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Practice Issue
The topic
The topic is the hand hygiene and the adherence to hand antisepsis guidelines to reduce HAIs.
The nursing practice issue related to the topic
The identified nursing practice issue is numerous hospital-acquired infections (HAIs) that deteriorate patients outcomes and decrease the quality of their lives. It is closely related to hand hygiene and antisepsis along with the adherence to hospital guidelines as their disregard is one of the central causes of the emergence of these problems.
The scope of the practice issue
HAIs can be determined as multiple infections patients might get while receiving medical care. At the moment, HAIs are one of the central causes of the appearance and development of numerous complications in individuals (Fernando et al., 2017). There are certain reasons for the emergence of HAIs which also include disregard for existing guidelines and poor hand hygiene. For this reason, the given aspect remains central to nursing as it guarantees improved outcomes and the decreased number of HAIs caused by the lack of knowledge in particular spheres.
The practice area
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Education
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Administration
How the practice issue was identified
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Safety/risk management concerns
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Unsatisfactory patient outcomes
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Significant financial concerns
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Clinical practice issue is a concern
HAIs remain one of the central reasons for the appearance of unsatisfactory patient outcomes and significant deterioration of their states. Treatment of individuals suffering from HAI demands extra spending and deteriorates the image of the healthcare sector (Fernando et al., 2017). Additionally, disregard of the existing guidelines concerning the hand hygiene and other practices gives rise to security concerns. Finally, the lack of knowledge about HAIs might corrupt clinical practice and outcomes. For this reason, the given aspects were identified.
Evidence that must be gathered
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Literature search
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Guidelines
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Expert Opinion
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Standards (Regulatory, professional, community)
The in-depth investigation of HAIs, their impact on patients, and their correlation with recommended guidelines can be performed using specific literature devoted to the issue, analyzing experts opinion, and appealing to the standards of practice introduced to minimize the threat and guarantee positive outcomes.
Evidence Summary
The practice problem
HAIs is one of the topical concerns of the modern healthcare. 1,7 million of new cases resulting in 99,000 deaths are reported every year (Fernando et al., 2017). Patients who acquire the needed care in healthcare settings and health specialists can be considered the identified population related to the problem.
The objectives of the related systematic review article
The first objective of the paper is the investigation of the effect surgical antisepsis has on preventing surgical site infections in multiple settings (Tanner, Dumville, Norman, & Fortnam, 2016). Another objective is to determine the impact surgical hand antisepsis has on colony forming units that can be found on specialists hands (Tanner et al., 2016).
The questions being addressed in the work and in the relation to the practice issue
The central question addressed in the paper is the effectiveness of specific surgical hand antisepsis procedures performed by medical professionals before any invasive procedure (Tanner et al., 2016). To avoid the transmission of microorganisms from one surface to another and prevent their growth, specific measures outlined by guidelines are introduced (Tanner et al., 2016). The given question is directly correlated with the selected practice issue as numerous HAIs appear due to the inappropriate hand hygiene or disregard of the basic norms outlined in guidelines. For this reason, the given paper becomes relevant for the research.
The interventions the authors suggest to improve patient outcomes
In the paper, the authors compare different types of interventions that can be applied to improve patients outcomes. These include surgical hand antisepsis, aqueous scrub, alcohol rubs, rubs with active ingredients, and surgical hand antisepsis using specific devices (Tanner et al., 2016). Despite the lack of data related to some approaches and barriers limiting their research, the authors conclude that the adherence to the existing guidelines related to hand hygiene and HAIs prevention might significantly improve the outcomes and guarantee better patients outcomes in different settings.
The main findings by the authors of the systematic review including the strength of evidence for each main outcome
The authors come to the conclusion that the there are multiple approaches to hand hygiene and numerous surgical hand antisepsis procedures that can be used by specialists to improve outcomes. Determination of their efficiency might be a complex task; however, it becomes apparent that the adherence to existing guidelines regardless of the chosen antiseptic minimizes the risk of the appearance and development of complications (Tanner et al., 2016). For this reason, the paper proves the high efficiency of hand hygiene in diverse settings.
Fernando, Gray, and Gottlieb (2017) offer a similar idea in assuming that the development of specific guidelines and standards of care helps to improve the situation and attain better results. This statement is supported by the statistical data from multiple medical units. For this reason, the paper proves the efficiency of these recommendations.
Evidence-based solutions that you will consider for your project
Regarding the information presented in the selected articles and the overall state of the problem, the following evidence-based solutions can be suggested. The first one is the creation and the further development of efficient guidelines concerning hand hygiene. It will help to use appropriate methods to minimize the risk of the development of HAIs in medical settings. The second evidence-based solution is the implementation of specific monitoring tools to ensure that all health workers adhere to the prescribed procedures and contribute to the improvement of the situation. Finally, additional training to provide specialists with the knowledge about the measures needed to reduce HAIs should be introduced.
Limitations to the studies
There were some barriers in the papers that might limit their use in the research project. First, the comparatively small scope of studies results in the lack of data about particular interventions and their role in promoting hand hygiene (Tanner et al., 2016). Second, the authors also assessed specific methods that are traditionally not applied in numerous medical units. That is why their further investigation and implementation can be doubted. However, despite these limits, the findings can still be utilized to obtain the needed results.
References
Fernando, S., Gray, T., & Gottlieb, T. (2017). Healthcare-acquired infections: Prevention strategies. Internal Medicine Journal, 47(12), 1341-1351. Web.
Tanner, J., Dumville, J., Norman, G., & Fortnam, M. (2016). Surgical hand antisepsis to reduce surgical site infection (Review). Cochrane Database of Systematic Reviews, 1, 1-101. Web.
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