Literature Evaluation Table Student Name: Change Topi 227550 ✓ Solved

Literature Evaluation Table Student Name: Change Topic (2-3

Literature Evaluation Table Student Name: Change Topic (2-3 sentences): For each of eight articles (Article 1 through Article 8), provide the following: Author, Journal (peer-reviewed), and permalink or working link to access article; Article title and year published; Research question(s) (qualitative) or hypothesis (quantitative); Purpose/aim of study; Study design (type of quantitative or qualitative); Setting and sample; Methods: intervention or instruments used; Analysis; Key findings; Recommendations; Explanation of how the article supports the EBP/capstone project.

Paper For Above Instructions

Change Topic (2-3 sentences)

Topic: Improving hand hygiene compliance among hospital healthcare workers to reduce healthcare-associated infections (HAIs). This capstone/EBP project assesses evidence for multifaceted interventions (education, reminders, alcohol-based hand rub availability, feedback) proven to increase compliance and decrease HAI rates.

Introduction

This literature evaluation summarizes eight peer-reviewed studies and major guidance documents addressing methods and outcomes for improving hand hygiene compliance in acute care settings. Each entry lists authors, journal, aim, design, methods, findings, recommendations, and how it supports an evidence-based practice (EBP) or capstone project focused on implementing a multimodal hand hygiene program.

Article 1

Pittet D., Hugonnet S., Harbarth S., et al. (2000). Lancet. Research question: Does a hospital-wide hand hygiene program increase compliance and reduce infection rates? Aim: Evaluate effectiveness of a multimodal program. Design: Prospective interventional before-and-after study. Setting/sample: University hospital, healthcare workers across wards. Methods: Campaign including alcohol-based hand rub introduction, education, performance feedback, and posters. Analysis: Observational compliance audits and infection rate surveillance. Key findings: Compliance rose markedly; HAI rates dropped (Pittet et al., 2000). Recommendations: Implement multimodal programs with alcohol rubs and feedback. Support for EBP: Demonstrates strong, real-world impact of a bundled intervention and justifies similar implementation in the capstone project (Pittet et al., 2000).

Article 2

World Health Organization (2009). WHO Guidelines on Hand Hygiene in Health Care. Purpose: Provide global evidence-based recommendations. Design: Guideline synthesis of literature. Methods: Systematic review, expert consensus. Key findings: Alcohol-based hand rubs recommended as the preferred method; multimodal strategy (system change, training, evaluation, reminders, institutional safety climate) is effective. Recommendations: Adopt WHO’s multimodal strategy and monitoring. Support: Serves as the authoritative framework and checklist for the capstone implementation and evaluation metrics (WHO, 2009).

Article 3

Erasmus V., Daha TJ., Brug H., et al. (2010). Infect Control Hosp Epidemiol. Research question: What factors influence hand hygiene compliance? Aim: Systematic review of compliance studies. Design: Systematic review. Methods: Literature search and synthesis of observational and interventional studies. Analysis: Qualitative synthesis and subgroup observations. Key findings: Compliance influenced by workload, availability of materials, and behavioral factors; single-component interventions less effective than multimodal ones. Recommendations: Use theory-informed, multimodal interventions. Support: Provides evidence base for choosing bundled approaches and identifying barriers to tailor the capstone intervention (Erasmus et al., 2010).

Article 4

Sax H., Allegranzi B., Uçkay I., Larson E., Boye K., Pittet D. (2007). J Hosp Infect. Research question: Can a user-centred 'Five Moments' framework improve hand hygiene understanding and training? Aim: Develop and test a practical framework. Design: Descriptive development and implementation. Methods: Framework design, education, and pilot evaluation. Analysis: Qualitative feedback and observational metrics. Key findings: The 'My Five Moments' approach improved clarity for training and monitoring. Recommendations: Integrate the framework into training and documentation. Support: Provides a training model and monitoring definitions central to measurement and staff education in the capstone project (Sax et al., 2007).

Article 5

Huis A., van Achterberg T., de Bruin M., et al. (2012). Implement Sci. Research question: Which implementation strategies best increase hand hygiene? Aim: Review effectiveness of implementation strategies. Design: Systematic review of implementation studies. Methods: Data extraction and thematic analysis. Key findings: Multifaceted, theory-informed interventions (education, reminders, feedback, leadership engagement) yielded the most consistent improvements. Recommendations: Employ implementation science frameworks and continuous quality improvement. Support: Informs selection of behavior-change techniques and implementation planning for the capstone (Huis et al., 2012).

Article 6

Kampf G., Löffler H. (2003). Clin Microbiol Infect. Research question: Are alcohol-based hand rubs effective and acceptable? Aim: Review efficacy and skin tolerance. Design: Narrative review. Methods: Experimental and observational studies synthesis. Key findings: Alcohol-based rubs are effective, rapid, and well tolerated; they increase compliance when made available at point of care. Recommendations: Prioritize alcohol hand rub procurement and placement. Support: Validates the system-change component of the capstone intervention—availability of ABHR as essential (Kampf & Löffler, 2003).

Article 7

Whitby M., McLaws ML., Ross MW. (2006). Infect Control Hosp Epidemiol. Research question: What behavioral factors drive noncompliance? Aim: Identify behavioral determinants. Design: Cross-sectional/qualitative studies synthesis. Methods: Observations and surveys. Key findings: Perception of risk, social norms, time pressure, and skin irritation are key drivers. Recommendations: Address behavioral determinants through targeted education and leadership modeling. Support: Guides the capstone’s staff engagement and tailored messaging components (Whitby et al., 2006).

Article 8

Fuller C., Savage J., Besser S., Hayward A., Cookson B., Cooper B. (2014). J Hosp Infect. Research question: Which specific behaviors and environmental factors form the greatest barriers? Aim: Observational study of hand hygiene behaviors. Design: Multisite observational study. Methods: Direct observations and contextual mapping. Analysis: Statistical comparison of behaviour frequencies. Key findings: Specific workflow patterns and hand hygiene opportunities cluster around certain tasks; targeted placement and prompts improved compliance. Recommendations: Use workflow analysis to position dispensers and prompts. Support: Provides operational guidance on dispenser placement and targeted reminders for the capstone rollout (Fuller et al., 2014).

Synthesis and Recommendations for the Capstone/EBP Project

Across studies and guidelines, the consistent evidence supports implementing a multimodal hand hygiene program: system change (alcohol-based hand rub at point of care), education using the 'Five Moments', monitoring with feedback, reminders, and leadership engagement (WHO, 2009; Pittet et al., 2000). The capstone should apply implementation science principles: pre-implementation workflow mapping, tailored education, ongoing audits with feedback, and outcome monitoring of compliance and HAI rates. Combining behavior-change techniques with structural supports maximizes the probability of sustained improvement (Huis et al., 2012; Erasmus et al., 2010).

Conclusion

The evidence base strongly favors bundled, context-sensitive interventions for improving hand hygiene compliance. The evaluated articles provide guidance for intervention components, measurement definitions, behavioral barriers, and expected outcomes. These studies together form a robust foundation for designing, implementing, and evaluating an EBP capstone project aimed at reducing HAIs via improved hand hygiene.

References

  1. Pittet D., Hugonnet S., Harbarth S., et al. (2000). Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 356(9238):1307–1312.
  2. World Health Organization. (2009). WHO Guidelines on Hand Hygiene in Health Care. Geneva, Switzerland: WHO.
  3. Erasmus V., Daha TJ., Brug H., et al. (2010). Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol. 31(3):283–294.
  4. Sax H., Allegranzi B., Uçkay I., Larson E., Boye K., Pittet D. (2007). "My five moments for hand hygiene": a user-centred design approach. J Hosp Infect. 67(1):9–21.
  5. Huis A., van Achterberg T., de Bruin M., et al. (2012). A systematic review of hand hygiene improvement strategies. Implement Sci. 7:92.
  6. Kampf G., Löffler H. (2003). Hand hygiene promotion: use of alcohol-based hand rubs. Clin Microbiol Infect. 9(8):863–869.
  7. Whitby M., McLaws ML., Ross MW. (2006). Why healthcare workers don't wash their hands: a behavioral explanation. Infect Control Hosp Epidemiol. 27(5):484–492.
  8. Fuller C., Savage J., Besser S., Hayward A., Cookson B., Cooper B. (2014). Contextual determinants of hand hygiene behaviour in UK hospital settings: observational study. J Hosp Infect. 86(4):234–240.
  9. Centers for Disease Control and Prevention. (2002). Guideline for Hand Hygiene in Health‑Care Settings. Atlanta, GA: CDC.
  10. Allegranzi B., Pittet D. (2009). Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect. 73(4):305–315.

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