For this group, the group developed a PICOT question to help narrow the research and find the used articles in this assignment. The question was, in hospitalized patients, do strategies such as handwashing and isolation precautions decrease the spread of infectious disease by nurses working in this environment? Based on the research question, the group focused on understanding the significance of containing healthcare-related infections primarily transmitted through contaminated hands among healthcare professionals. Bimerew and Muhawenimana (2022) show that hospital-acquired infections result from draining wounds or pathogens, colonized patient’s skin areas, bed linens, patient gowns, and bedside furniture. Hand hygiene is the single most known effective precaution against the spread of infection in healthcare facilities.
Infection containment is a global issue responsible for healthcare workers (HCWs) and patient mortality and morbidity. The significance of this problem lies in understanding that ensuring the spread of infection is prevented critical in controlling infectious diseases in healthcare facilities. Danaei et al. (2021) show that nurses had acceptable attitudes and knowledge towards controlling infections from a systematic review by World Health Organization (WHO). However, poor practice and the inability to comply with infection control guidelines were responsible for the continuous spread of infectious diseases among nurses. Suliman et al. (2018) show that healthcare-associated infections are medical problems in healthcare facilities, with an estimated 1.4 million people globally getting infection complications from hospitals. In Jordan, for example, Suliman et al. 2018) show that infectious diseases are among the main causes of morbidity. The researchers argue that since nurses form part of the healthcare team in the country, they are responsible for implementing patient isolation and adherence to disease-specific and standard isolation precautions.
This paper aims to develop an understanding that effective hand hygiene and isolation are significant measures in minimizing the spread of infectious diseases by nurses and protecting them from acquiring nosocomial infections. Hammerschmidt and Manser (2019) have shown that nurses’ increased knowledge, attitude, and behavior are critical since it helps enhance standard safety precaution compliance among nurses. Maroldi et al. (2017) further argue that regardless of the healthcare setting, nurses and the healthcare leadership are responsible for ensuring infection prevention measures are applied and considered essential for care quality. Therefore, this paper emphasizes the significance of adherence to transmission-based precautions and standard precautions, which are among the core components in safeguarding nurses and patients from transmitting microorganisms responsible for the infections.
Evidence Matrix Table: Appendix A
The evidence matrix table, or the data summary, provides the used references published within the past five years. The table provides the question of the study, hypothesis, or purpose, and the variables, either independent or dependent. Moreover, it also presents the study design of each article, and addresses the sample size and selection applied in all the articles used in this paper. Further, though the table, the data collection approaches used are addressed alongside the major findings from each used article and how they relate to the clinical problem.
Description of Findings
From the first article used in this paper, the researchers purpose their article to examine nurses’ knowledge, attitudes, and practices towards compliance with handwashing in a psychiatric hospital in South Africa. Moreover, they hypothesized the existence of an association between demographic variables and hand hygiene practice (Bimerew and Muhawenimana, 2022). The variable used in this research are demographic variables, including knowledge, attitude, and practice among nurses, for independent variables, and hand hygiene practice as the dependent variable (Bimerew and Muhawenimana, 2022). In the second article, Danaei et al. (2021) purpose their study to evaluate nurses’ and auxiliary nurses’ knowledge, attitudes, and practices (KAP) towards isolation precautions (IP). From this research, the independent variables are the same as those used by Bimerew and Muhawenimana, as Danaei et al. use knowledge, attitude, and practice for their independent variables. However, in contrast to Bimerew and Muhawenimana, Danaei et al. use infection prevention and control as their dependent variables.
The research in the third article is formulated based on the aim to enhance organizational factors’ understanding of compliance with managing infection prevention by focusing on hand hygiene in nursing homes. Hammerschmidt and Manser (2019) use nurses’ knowledge, behavior, and compliance as their independent variables to achieve their purpose. The only familiar independent variable in the first two articles is knowledge, while the other two, nurses’ behavior and compliance, contrasting with nurses’ attitude and practice, are used in the first two articles. Similarly, the dependent variable in this article, hand hygiene, differs from what Bimerew and Muhawenimana (2022) and Danaei et al. (2021) use as their dependent variables. The fourth article identifies issues that determine professional adherence to microorganisms’ prevention transmission precautions in primary healthcare (Maroldi et al., 2017). The dependent and independent variables in this article differ from those in the first three articles. Lastly, Suliman et al. (2018) aim to evaluate nurses’ practice and knowledge relative to isolation precautions in Jordan. Similarly, no similarities exist between the variables in this article and those used in the first four articles.
Relative to the study design, only the fourth article used qualitative research in their article and selected focus groups as their primary data collection approach. The remaining four articles use surveys and questionnaires for their quantitative research, despite similarities and differences in research design. For example, while Hammerschmidt and Manser, Danaei et al., and Suliman et al. use a cross-sectional approach, each differs in applied design. The latter use descriptive design, similar to what Bimerew and Muhawenimana use. Further, while Hammerschmidt and Manser utilize a mixed-methods study, Danaei et al. use a cross-sectional study.
The first article shows there was discrepancies in attitudes, knowledge, and handwashing processes. Bimerew and Muhawenimana’s (2022) study’s population was 195 nurses, where 117 were female nurses, 79 were male, 48 registered nurses, 43 enrolled assistance nurses, and 25 auxiliary nurses. Nurses 40 years and above were 80, while those between 30 and 40 years were 70 (Bimerew and Muhawenimana, 2022). Danaei et al.’s (2021) study show that 589 and 90 nurses were female and male, 624 were nursing staff, their ages were 29.72±6.72 years, and almost three-quarters, 495 had passed standard precaution program training. Suliman et al. (2018) show only one-third were male participants, 65 percent of all participants had a bachelor’s degree, their mean age was 34±4.9 years, and 90 percent demonstrated good isolation precaution knowledge. The findings confirmed the existence of a low compliance, by nurses, with the standard isolation practice.
From the third article, the findings showed that most nursing manager and nurses had an effective knowledge about hand hygiene processes. Hammerschmidt and Manser (2019) show that the overall response rate was 183, 132 were female, 85 were licensed nurses, their age averaged 47 years, and they had ≤5 years with their institutions. For their qualitative data, all 27 nursing managers accepted the invitation, 89 percent were female, 33 percent were aged between 50 and 59 years, all worked day shifts, and had 11-15 years of experience. Maroldi et al. (2017) show all 20 professionals participated in the focus group where 11 were community health workers, 5 were nursing assistants, and 4 were nurses. Most, 18, were women and had an average of 4.9 years of working experience.
The research findings support the group’s clinical problem by showing that low-risk perception, insufficient in-service training, weakness in knowledge, and infrastructure limitations are critical contributors to infectious diseases. Moreover, compliance relied on role modeling and availability in the immediate work area despite hand equipment and hygiene availability. Educational level impacted handwashing knowledge, and knowledge gaps exist among respondents about hand hygiene aspects. No further evidence is essential to answer the group’s clinical problem from the findings. The two questions that can help guide the group’s work are, can the absence of handwashing and isolation strategies jeopardize human resources where suffering nurses and physicians already exist? Is there transparency in how healthcare environments approach hand hygiene and isolation processes?
The findings from the five articles have shown that by failing to adhere to transmission-based and standard precautions, nurses become responsible for helping the spread of infectious diseases. Aspects such as nurses’ knowledge, attitude, behavior, and compliance are essential in how handwashing and isolation strategies effectively prevent infections. There are knowledge gaps in how nurses respond to hand hygiene and isolation practices, and healthcare facilities must emphasize in-service training and infrastructure to guarantee effective application of the strategies. The significance of the strategies is underpinned in the clinic question, in the evidence matrix table, and how the findings are described.
Bimerew, M., & Muhawenimana, F. (2022). Nurses’ knowledge, attitudes, and practices towards hand washing in infection prevention and control at a psychiatric hospital. International Journal of Africa Nursing Sciences, 16, 100399.
Danaei, M., McLaws, M.-L., Shayan, Z., Momeni, M., Ammonia, S., Yaghout, Y., Fereidoni, F., & Askarian, M. (2021). Knowledge, Attitudes, and Practice Toward Isolation Precautions Amongst Nurses and Auxiliary Nurses in Nemazee Hospital, Shiraz, Iran. Shiraz E-Medical Journal.
Hammerschmidt, J., & Manser, T. (2019). Nurses’ knowledge, behavior, and compliance concerning hand hygiene in nursing homes: a cross-sectional mixed-methods study. Bmc Health Services Research, 19, 1, 547.
Maroldi, M. A. C., Dias, A. A. L., Zem-Mascarenhas, S. H., Figueiredo, R. M., Felix, A. M. S., Kawagoe, J. Y., Ferreira, S. A., & Timmons, S. (2017). Adherence to precautions for preventing the transmission of microorganisms in primary health care: A qualitative study. Bmc Nursing, 16, 1.
Suliman, M., Aloush, S., Aljezawi, M., & AlBashtawy, M. (2018). Knowledge and practices of isolation precautions among nurses in Jordan. American Journal of Infection Control, 46, 6, 680-684.
Appendix: Evidence Matrix Table
|Study Design||Sample |
|Data Collection |
|1||Bimerew, M., & Muhawenimana, F. (2022). Nurses’ knowledge, attitudes, and practices towards hand washing in infection prevention and control at a psychiatric hospital. International Journal of Africa Nursing Sciences, 16, 100399.||To examine nurses’ knowledge, attitudes, and practices towards compliance with handwashing in a psychiatric hospital in South Africa. |
The researchers hypothesized the existence of an association between demographic variables and hand hygiene practice.
|The Independent variable was demographic variables (knowledge, attitude, and practice). The dependent variable was hand hygiene practice||Descriptive survey||the researchers selected 195 from 381 nurses||Questionnaire||There was a discrepant knowledge, attitude, and hand washing practice among genders. |
No statistically significant association between attitudes and gender toward handwashing.
Educational level impacted handwashing knowledge.
Knowledge gaps exist among respondents about hand hygiene aspects.
|2||Danaei, M., McLaws, M.-L., Shayan, Z., Momeni, M., Aminnia, S., Yaghout, Y., Fereidoni, F., & Askarian, M. (2021). Knowledge, Attitudes, and Practice Toward Isolation Precautions Amongst Nurses and Auxiliary Nurses in Nemazee Hospital, Shiraz, Iran. Shiraz E-Medical Journal.||To evaluate nurses and auxiliary nurses’ knowledge, attitudes, and practices (KAP) towards isolation precautions (IP).||Independent variables were knowledge, attitude, and practice. Dependent variables were infection prevention and control precautions.||Cross-sectional study||From 734, 676 nurses and auxiliary nurses working at Namazee Hospital of Shiraz completed the questionnaire.||Questionnaires||The practice means the score was lower than attitude and knowledge in every domain.|
|3||Hammerschmidt, J., & Manser, T. (2019). Nurses’ knowledge, behavior, and compliance concerning hand hygiene in nursing homes: a cross-sectional mixed-methods study. Bmc Health Services Research, 19, 1, 547.||The purpose was to enhance organizational factors’ understanding about compliance with managing infection prevention by focusing on hand hygiene in nursing homes.||Independent variables were nurses’ knowledge, behavior, and compliance. |
The dependent variable was hand hygiene.
|A cross-sectional mixed-methods study.||The quantitative study surveyed 183 out of 431 nurses; however, the final sample was 165. |
In the qualitative study, the researchers interviewed 27 nursing managers.
|Survey and interviews||Most nurses and their managers held effective hand hygiene processes knowledge. |
Despite hand equipment and hygiene availability, compliance relied on role modeling and availability in the immediate work area.
|4||Maroldi, M. A. C., Dias, A. A. L., Zem-Mascarenhas, S. H., Figueiredo, R. M., Felix, A. M. S., Kawagoe, J. Y., Ferreira, S. A., & Timmons, S. (2017). Adherence to precautions for preventing the transmission of microorganisms in primary health care: A qualitative study. Bmc Nursing, 16, 1.||The purpose was to identify issues that determined professional adherence to microorganisms prevention transmission precautions in primary healthcare.||Independent variables adherence to precautions. |
Dependent variables microorganisms transmission prevention in primary health care.
|Qualitative||20 professionals||Focus groups||The emergent themes were low-risk perception, insufficient in-service training, weakness in knowledge, and infrastructure limitations.|
|5||Suliman, M., Aloush, S., Aljezawi, M., & AlBashtawy, M. (2018). Knowledge and practices of isolation precautions among nurses in Jordan. American Journal of Infection Control, 46, 6, 680-684.||To evaluate nurses’ practice and knowledge relative to isolation precautions in Jordan.||The independent variable was isolation precautions. |
Dependent variables were nurses’ practices and knowledge.
|Cross-sectional, descriptive design.||Out of 400, 247 questionnaires were completed and returned.||Questionnaire||Most nurses have good knowledge about isolation precautions. |
Bachelor degree nurses performed better at knowledge examinations compared to diploma nurses.
There is no significant difference in self-report and knowledge scores based on previous isolation guidelines and training.