1
R&T Del 6
Student’s Name
Institutional Affiliation
Course
Instructor’s Name
Date
R&T Del 6
Potential Practice Problem
The potential practice problem I identified is the high incidences of nosocomial infections among patients in the hospital setting. Patients acquire the infections 48 hours after admission in hospital environments, 30 days after undergoing surgical procedure, 3 days after being discharged from hospital and getting treated for an infection different from the one that caused their admission (Demmler-Harrison, 2018) .Hospital acquired infections cause mortality, morbidity, high treatment costs to a tune of approximately $5 Billion annually (Demmler-Harrison, 2018). Hospital acquired infections relate to immunosuppression among inpatients, underlying medical conditions, and invasive medical procedures (Demmler-Harrison, 2018). In most cases, the infections occur as a result of invasion by antibiotic microorganisms like Gram negative, Candida MRSA, VRE. Transmissions of the organisms that cause the Hospital acquired infections occur through contact with hospital surfaces and air. Those transmitted by air include Aspergillus, Varicella, and Tuberculosis. Microorganisms that cause nosocomial infections by contact are Streptococcus aureus, Gram-negative bacilli, and enterococci. Patients commonly get infected by HAIS like gastroenteritis, pneumonia, meningitis, urinary tract infections and surgical site infections. The symptoms of the infections may entail fever; wound discharge, headache, shortness of breathing, cough, vomiting, nausea, fever, and diarrhea.
Evidence Based Practice Question
P
Patient, Population, or Problem
Hospitalized patients with urinary tract infections, who contact nosocomial infections 48 hours after their admission in hospital as they subjected to catheterization procedures. The problem is persistent, since some healthcare workers do not follow guidelines of prevention.
I
Intervention
Hand washing
C
Comparison
Effective as regular disinfection of hospital facility surfaces
O
Outcome
Reduced incidence rate of nosocomial infections
Formulated Question
Among hospitalized patients, is observing hand hygiene more effective in preventing hospital-acquired infections than hand sanitizer use?
Evaluation of Evidence
My search findings regarding how to prevent nosocomial infections yielded several articles but I chose two to focus on which are titled “Role of Hand Washing to prevent Nosocomial infection in Neurosurgical wards at RIMS Ranchi Jharkhand India” by Dr Alok Chandra Prakash and Dr Anand Prakash and “Comparative efficacy of hospital disinfectants against nosocomial infection pathogens”. In the first article that focuses on hand washing, the authors start by explaining the burden that nosocomial infection places on hospitals and the affected patients and also explores the role of handwashing in preventing nosocomial infections. Further, the article has elaborated the possible causes of the high prevalence rate of the infections both in the developed, middle and developing countries. The authors have acknowledged that hand washing would be effective means of preventing this problem. However, lack of training and commitment to codes and regulations of nosocomial infections preventions are the main contributing factors to the continued existence of the problem in the hospital setting. The authors are credible as they refer to reports of the World Health Organization and European epidemiological surveys to show the rate of the infections. Additionally, the article explains adequately conditions that must be present for the infection’s transmission to occur. According to (Prakash, 2018) for nosocomial transmission to occur, there must be a surface, a host and a contact person. This is important as it gives an idea of how to terminate transmission by hand washing. Among the steps it acknowledges that a contaminated surface or a host must be present for transmission to occur. The scientists also give the positive and negative aspects of hand washing meaning it is not the most effective method. They conclude by acknowledging regular hand washing is a good practice that would help control or prevent the spread of the infections among patients but not effective due to lack of compliance among healthcare workers.
Strengths
The method of data collection was qualitative, hence provided in-depth information regarding the study question
Methodology was well articulated
The sample size was desirable and uneven as it included nurses from all departments and patients.
Weaknesses
The study did not focus directly on the relationship between nosocomial infections and hand washing.
The methodology was not detailed
The study lacked discussion of the results
Regarding the first study, the authors gave a suitable abstract on the relation between nosocomial infection and nursing workload. Further the authors of the article incorporated methodology, results and conclusions. Unfortunately, the paper did not directly address the significance of hand washing in addressing nosocomial infections. However, the second article clearly describes the background of the study. Further, it states it the research focused on the efficacy of various disinfectants against hospital-acquired infections. Finally, it explains the methodology uses, results and the concussions. Therefore, the second article is more credible compared to the first article.
The results of the second article show that even though disinfectants are useful in preventing nosocomial infections transmission, some of them may not be effective. However, the method the authors used to do the study was not effective as they did not test the efficacy of antibiotics with various microorganisms. They focused on only Burkholderia cepacia ATCC 10673 and Enterococcus faecalis ATCC 29212. However, by testing the efficacy of 27 disinfectants against the two strains of the bacteria makes the research more credible. According to (Amini Tapouk, Nabizadeh, Mirzaei, Hosseini, Yousefi, & Valizade Hasanloei, 2020), biocide resistant disinfectants exist, thus it some disinfectants may not be effective in preventing some nosocomial infections in hospital settings. The conclusion of the study is very precise as it explains the exact concentrations of each disinfectant that would be able to kills pathogens that may exist on both surfaces and on hospital equipment.
Strengths
Detailed and relevant introduction
In-depth information in literature review
The paper was focused on the relationship between nosocomial infections and hand-washing
Weakness
Lack of methodology
Lack of discussion of results
The study was focused mainly on neurosurgery ward alone, thus biasness.
Evidence-Based Solution
After considering the results of the two studies, it would be appropriate for healthcare workers to use an integrated or multifaceted approach to prevent the emergence and spread of the infections in their hospital settings. The reason for doing so is that the first study indicates that hand washing is effective but some healthcare workers do not comply either with the codes and regulations or procedures for preventing the infections. However, the second article indicates disinfectants vary in terms of their efficacy, thus some strains of nosocomial infection causing microorganisms may thrive despite their use due to their anti-bactericidal capacity. Consequently, healthcare workers should use both alcohol-based hand sanitizers to clean their hands and also use appropriate disinfectants to clean hospital surfaces regularly in order to prevent the incidences of hospital acquired infections.
References
Amini Tapouk, F., Nabizadeh, R., Mirzaei, N., Hosseini Jazani, N., Yousefi, M., & Valizade Hasanloei, M. A. (2020). Comparative efficacy of hospital disinfectants against nosocomial infection pathogens. Antimicrobial Resistance & Infection Control, 9(1). https://doi.org/10.1186/s13756-020-00781-y
Demmler-Harrison, G. J. (2018). Healthcare-associated viral infections: Considerations for nosocomial transmission and infection control. Healthcare-Associated Infections in Children, 229-257. https://doi.org/10.1007/978-3-319-98122-2_14
Prakash, A., & Prakash, A. (2018). Role of Hand Washing to prevent Nosocomial infection in Neurosurgical wards at RIMS Ranchi Jharkhand India. Journal of Medical and Dental Science Research, 2018(6), 54-60.