Solution
Soumi answered on
May 17 2020
SYSTEMATIC REVIEW ON THE EFFECTIVENESS OF EDUCATION SESSIONS TO INCREASE KNOWLEDGE AND IMPROVE HAND HYGIENE COMPLIANCE
Subject Name: Minor Project
Subject Code: SNPG905
Author Details:
Executive Summary
The objective of the cu
ent systematic review has been to evaluate the significance of these education sessions for the registered nurses working in ICUs. This has been achieved with the help of framing a PICOT question of “How are education sessions more effective than no intervention or any other interventions like reminders or posters for increase knowledge and improve hand hygiene compliance amongst registered nurses working in ICUs?”
The databases considered for the relevant search of the sources that could contribute to the systematic review are MEDLINE and CNAHL out of the wide range of databases considered before. The keywords such as ‘registered nurses’, ‘ICU’, ‘hand hygiene’ and ‘education sessions’ were used to select randomised controlled trial (RCT), observational and experimental studies, which were specifically published in English between 2013 and 2018.
A total of 7 papers were considered, out of which 3 papers followed observational study design, and one of each of the rest 4 followed a prospective, interventional study design, an experimental study design, a clustered randomised controlled trial study design and a self-administered questionnaire based cross sectional research design. 6 out of 7 papers gave the view that education sessions benefit the nurses for gaining knowledge about hand hygiene for working in ICUs.
Table of Contents
Background 4
Rationale for conducting the research 5
Research Objectives 5
Criteria for considering research papers in this review 6
Inclusion Criteria (for the identified PICOT Question) 6
Exclusion Criteria 6
Search Strategy 7
PRISMA flow diagram for search strategy 7
Assessment of methodological quality 8
Data Extractions 8
Data Extraction Table 8
Data Synthesis 15
Findings 15
Synthesized Findings 16
Results of the Review 16
Summary of methodological quality 17
Discussion 17
Research Limitations 18
Conclusions 18
Implications for Practice 19
Implications for Research 19
References 20
Background
Hand hygiene is a basic requisite of nursing practice that cannot be ignored on any instance. Hands, being one of the most used external body parts for the daily activities, are responsible for coming in contact with the infection-causing agents as well as acting as a medium for these agents to spread infections more commonly and conveniently (Jones, 2014). Therefore, compliance with all the rules, regulations and requirements of maintaining hand hygiene within the nursing practice is indispensable for the nurses. This is specifically becoming an issue presently, in terms of those registered nurses, who are working with patients in ICU (Intensive Care Unit). It is so because as mentioned by Fa
ega and Vila (2013), within intensive care facilities, the registered nurses have to perform a large number of duties, such as attaining to their emergency conditions, maintaining cleanliness of the patient environment, cleaning the patients or service users, feeding them, handling their stools, sputum, urine or other body fluids and protecting them from infections that can possibly occur within the care environment. Therefore, the risks of spreading infections, if hand hygiene policies or rules are not followed, are more in case of registered nurses, working within the ICUs, than other departments of nursing care practices.
In the views of Bianco et al. (2013), wearing protective equipment such as gloves, masks and aprons have been deemed important in the previous nursing care practices. However, the significance of complying with the hand hygiene rules have not been sufficiently realised by the nurses. Most of them either have been ignorant of the significance of the same or have not known the actual proper method of maintaining hand hygiene. According to Savard and Perl (2014), lack of training or evidence-based practices might have generated the ignorance amongst them, which is why the impartation of proper knowledge of the same is the cu
ent need in this sector. As supported by Reichardt et al. (2013), training and education, along with the use of suitable tools for spreading awareness regarding hand hygiene, its accurate method, as well as its significance could be potent to
ing about the positive change in their habits. The research outlined here might be able to draw a conclusion to the identified research problem, by reviewing prevailing quantitative researches on this issue.
With the help of this study, it could be expected that the registered nurses are able to be understand the significance of maintaining cleanliness and hygiene of hands, while they are working in the ICUs. A paper by Madani, Althaqafi and Alraddadi (2014) emphasises on the use of disposable gloves, while handling blood, stool and urine for patients; however, does not specifically emphasises on the maintenance of hand hygiene for being in contact with the critical patients. Similarly, another paper by Weening-Ve
ee et al. (2013), focuses on the use of hand hygiene within the critical care facilities; however, failing to focus on its implementation by the registered nurses. Papers on organising education sessions for the entire knowledge about hand hygiene have also not been found sufficiently. Hence, it can be viewed that basing the cu
ent research by extending on the prevailing ones could be a better way to elaborate the literature on this topic, along with generating a paper that specifically addresses the area of using education sessions for increasing knowledge and improve hand hygiene compliance by the registered nurses working in the ICUs. Hence, this research holds its particular significance in the field of nursing care practices.
Rationale for conducting the research
The issue of maintaining the hand hygiene within the ICU is a crucial and indispensable one, because patients are contacted by the registered nurses with their hands only (Evans, 2013). Since the use of hands is one of the most common reasons for the spreading of infections, therefore, it is very important that the hands are always kept, sterile and free from the agents of the infection. However, as argued by Grigoriadis et al. (2013), within the ICU, this is quite a big challenge for the registered nurses to maintain their hand hygiene, because very frequently, they have to deal with the critical cases of the patients that might not leave with them sufficient time for executing the activities of proper hand hygiene.
In such cases, as suggested by Stoffer et al. (2015), education of the registered nurses is very useful as that might be make them aware of the significance of hand hygiene in nursing care, simultaneously, training them in the accurate procedure of maintaining hand hygiene so that ICU patients are not faced with risks of infection. Thus, this research is important in terms of reviewing the prevailing literature on the provision of education sessions and their affectivity in making the registered nurses aware of the hand hygiene regulations as well as policies, while working in the ICUs.
Research Objectives
The aim of this research is to conduct a systematic review of relevant quantitative research papers for analysing the effectiveness of education sessions to increase knowledge and improve hand hygiene compliance. The key aim of the research focuses on increasing the awareness amongst the registered nurses, who are especially working in critical care facilities such as ICUs.
Based on this aim, the objectives are:
· To understand the concept of multimodal education sessions and use of various interventions such as posters and reminders
· To evaluate the significance of these education sessions for the registered nurses working in ICUs
· To analyse the effectiveness of these education sessions in increasing knowledge and improve hand hygiene compliance
· To locate quantitative research papers, such as randomised controlled trials, cohort studies, non-randomised controlled trials, experimental, observational or quasi- experimental researches on the identified PICOT question, for conducting a systematic review on this issue
Criteria for considering research papers in this review
Inclusion Criteria (for the identified PICOT Question)
The inclusion criteria for selecting the relevant articles for the systematic review have been based on the PICOT question for the identified research problem. The PICOT question identified for the research topic is:
“How are education sessions more effective than no intervention or any other interventions like reminders or posters for increase knowledge and improve hand hygiene compliance amongst registered nurses working in ICUs?”
It has the following PICOT elements, which were considered as the inclusion criteria:
P (Types of Participants or Population): Registered nurses working in ICUs
I (Interventions): Education sessions
C (Comparison): No intervention or any other interventions like reminders, posters
O (Outcomes of Interest): Increase knowledge and improve hand hygiene compliance
T (Time): 7 weeks
Exclusion Criteria
As mentioned by Bray et al. (2015), exclusion criteria are those, which help the researchers to exclude the i
elevant sources from the vast pool of resources. These are usually opposite to the inclusion criteria or everything excluding the ones mentioned in the exclusion criteria. For the cu
ent research exclusion criteria are as follows:
· Any article that is not about registered nurses, such as those about the assistant nurses, paramedics, doctors, care providers, physiotherapists, and other care professionals
· Articles not pertaining to emergency care set-ups such as those in case of ICUs
· Papers concerning hygiene in any other way such as those not pertaining to hand hygiene
· Papers beyond 2013 and those published in English
Search Strategy
Firstly, the key words ‘registered nurses’, ‘ICU’, ‘hand hygiene’ and ‘education sessions’ were listed. Secondly, a limited search was conducted using CINAHL and MEDLINE, where these key words and pre-defined subject headings were used. Sometimes, the modified key words were also considered as combined search...