Hand Hygiene Knowledge and Attitudes

This paper has specific research aims. The researchers wanted to find out the different perceptions, practices, and attitudes of undergraduate students towards hand hygiene. The study sought to explore reasons for any existing differences and use the findings to review and influence the development of future education materials. These materials will be structured to address any existing gaps in hand hygiene theory-practice. University education curriculum developers, student nurses, and future hand hygiene researchers will find this study of interest. Curriculum developers will rely on the study findings to include units that address hand hygiene in all undergraduate classes. From the study findings, a topic touching on WHO ‘5 Moments’ for hand hygiene, is largely taught in third year but ignored in the second year. The curriculum developers will need to consider if there is a need to introduce the same topic in the early stages. Student nurses might use the research to enhance their knowledge on hand-washing hygiene. Second-year students can for instance conduct more research to find out why there were differences in the responses the researchers obtained from first-year and third-year students. Future researchers will use this study to develop research questions. They will for example want to find out how a student’s knowledge of hand hygiene influences his or her practice.

The researchers used mixed methods in conducting this study. The methodologies used are the most appropriate for the aims of this kind of research. Mixed methods help in determining and understanding the differences between quantitative results and qualitative findings in research and strengthen the study’s conclusion (Schoonenboom and Johnson, 2017). This makes it easy for a researcher to make a direct comparison between qualitative and quantitative data and come up with valid inferences. In the provided paper, for instance, the researchers used mixed methods to determine the number of students who had any knowledge of the WHO’s‘5 Moments’ for hand hygiene. The number was obtained by questioning undergraduate students of different classes. This assists the researcher in determining whether there is a difference in handwashing knowledge between these groups of students. The study aimed at using the findings to inform the development of future study materials for undergraduate students. Through the quantitative method, the researchers found out the number of students in each class who were conversant with the national hand hygiene. In the qualitative research, the researchers determined the classes in which these students belonged. By combining the two, the researchers could determine the level of difference in knowledge between the two groups of students.

Although much emphasis is put on improving hand hygiene compliance, this simple task is often ignored by some healthcare workers. A number of possible reasons are given for non-compliance. One of them is time constraints. High workload for healthcare workers is associated with non-compliance. If there is no easy access to a hand-rub solution at the time of contact with the patient, it is highly unlikely that the caregiver will adhere to the hand hygiene protocol. If hand washing stations are far, a person may consider it as a time-wasting practice to wash his or her hands after every contact they make. The shortage of staff makes it more difficult to comply with hand hygiene. One staff member has to attend to many clients and has limited time to frequently wash his or her hands. Another possible reason is peer influence. Junior staff members and students tend to copy the behaviors of their senior counterparts. During their initial stages at the healthcare facilities, juniors and students are taught to strictly comply with handwashing hygiene. As time progresses, they observe that other members within the workplace never bother to wash their hands regularly. This creates the notion that hand hygiene is not that important and they eventually abandon the practice.

The research authors organized a survey targeting second-year and third-year students. The students were recruited into the study through a turning point system. This is an audience response system where survey participants can interact with the researcher by submitting responses to survey questions using a small handset (Schmidt et al., 2020). The research authors had obtained permission from the school’s research dean in terms of ethics. Ethical approval to recruit students in the study was however not necessary as the study was considered to be an educational evaluation. Research authors developed a questionnaire with specific questions for the students. Respondents were required to answer these questions to demonstrate their level of awareness, knowledge, and attitudes towards hand hygiene. Student nurses' participation in the study was purely voluntary. No one was forced to participate in the survey or respond to the questionnaire against his or her will. None of the students declined to participate in the research. The study authors requested a written consent from the students to have the data obtained from the study be used for publication and educational purposes. All the students who participated in the study accepted the request and handed in written consents to the researchers.

The WHO ‘5 moments for hand hygiene is a campaign introduced by the World Health Organization in the year 2009 (Chou, Achan, and Ramachandran, 2012). The campaign was one of the organization’s major efforts in addressing the burden of healthcare-associated infections in the world. The WHO’5 moments for hand hygiene program defines specific occasions when healthcare workers should observe hand hygiene. The first occasion is before touching a patient. This protects the patient from being infected with healthcare-associated microorganisms. The healthcare worker is advised against shaking hands with the patient, moving him or her around, or performing a clinical examination before observing hand hygiene. The second occasion is before the clean/aseptic procedure. Healthcare providers should clean their hands between the last exposure to a surface and before accessing a site that is considered an infectious risk for the patient. Immediately after a body fluid exposure risk, the healthcare provider should clean their hands. This guideline must be observed before a new hand-to-surface exposure. After touching the patient and before handling any other object outside the patient’s environment, healthcare providers are required to observe hand hygiene. The last moment for hand hygiene takes place between a healthcare providers’ hand exposure to a surface in a patients’ environment and hand exposure outside the patients’ environment but without touching the patient.

The data collection methods used in the research were surveys and questionnaires. A total of 179 student nurses were selected to participate in the survey. The authors administered similar questions to the entire sample size through the turning point system. Researchers developed a set of questions for the students. The respondents were supposed to demonstrate knowledge, awareness, and attitude towards hand hygiene by answering the questionnaire. For this particular study, surveys and questionnaires were the most appropriate. The study process involves a large amount of information obtained from large sample sizes. In such instances, a questionnaire is one of the most appropriate data collection methods (Jones, Baxter, and Khanduja, 2013). Collecting data through a questionnaire is relatively quick and effective. In the study research provided, the number of the respondent is quite high and there are only two research authors. Forming a set of questions and presenting them to the student nurses could save time and money spent in conducting the research. When done well, surveys are among the best data collection methods for obtaining an individual’s views and experiences. Student nurses’ opinions and behaviors obtained from the survey can be used to make important decisions that will influence school curriculum in the future.

The research authors used statistical data analysis and diagnostic data analysis methods. In a study where the researcher wants to assess the current process of learning and use the findings to inform the future process, both statistical and diagnostic analysis is most appropriate. To identify the patterns of student nurses in hand hygiene behavior, the researchers apply the knowledge of statistics in transforming numbers into percentages. In a statistical procedure, the researcher collects data and uses it to test the relationship between two statistical data sets. In the study provided, the number of student nurses responding to a given survey question in the second year is tested against the number of respondents in the third year. The research authors use diagnostic data analysis to answer the question as to why student nurses gave varying answers to the survey questions. In analyzing the data, the study relies on literature reviews to come up with possible answers on the varying opinions, knowledge, and attitudes of different people towards hand hygiene. These two data analysis methods are suitable for the kind of study provided. The diagnostic data analysis method helps the researcher in assessing the learning that has occurred during a particular stage of the learning process. The researchers can use this information in determining what needs to be taught in the future and the manner in which it should be done.

Descriptive Statistics are analytics coefficients that a researcher uses to analyze, summarize and present data obtained from a specific sample size or the entire population (Kaur, Stoltzfus, and Yellapu, 2018). This type of analysis helps in describing and understanding the components of specific data in research by providing brief summaries about the samples obtained. Descriptive statistics are further subdivided into three categories which include measures of central tendency, measures of variability, and frequency distribution. In quantitative research, authors may use descriptive statistics to come up with information regarding a data set. After conducting a study, the research authors may use a measure of central tendency to come up with a single value that helps readers to identify a central position within the data. This makes it easier for readers to draw conclusions and make decisions. The research authors may use a measure of central tendency to make summary statistics that represent the amount of dispersion in a large set of data. The use of frequency distribution in a descriptive analysis helps in making a simplified overview of all the distinct values in the obtained data. A research author may use a frequency distribution to explain to the reader the number of times that something occurred or is occurring.

The research authors used bar charts to present their findings. A total of three charts were used in the research. The first chart illustrates the total number of students who demonstrated awareness of the hand hygiene campaign at the time the survey was being conducted. Second-year students were represented by a blue bar while a red bar was used to represent third years. This pattern was repeated in the second and third charts but the questions addressed in each chart were different. The second chart for instance addressed the number of student nurses who had heard of the WHO’5 moment. The third chart gave an analysis of respondents who thought alcohol-based hand rubs can be used in instances where a patient has diarrhea and vomiting complications. The data findings represented in the charts are simple and clear. The scales and figures displayed are comprehensive. At the first glance, a reader can immediately tell the estimate of the number of student nurses who participated in the survey, the classes they were in, and the percentage of respondents who gave specific responses to particular questions. The distinct colors of the two bars representing classes of students ensure that the reader will have an easy time differentiating between the two.

The findings of the study relate well to the title and aims of the research. The methods and techniques used by the research authors were best suited in testing the student nurses’ awareness, knowledge, and attitude towards hand hygiene. Almost every aspect of the study is based on hand hygiene which is the title of the research project. There is consistency in the data collection and analysis procedure. One of the major aims of the study was to find any existing differences in knowledge and attitude towards hand hygiene practices by student nurses of different classes. To achieve this, the research authors specifically obtained a survey sample of student nurses from the second and third years. The results obtained from these students could be relied on as they had the first-hand experience and the questions directly touched on their day-to-day activities. The sample size was relatively huge. A large sample size allows a researcher to have a more precise mean value resulting in a small margin of error. The reliability of a study can be estimated by comparing different versions of similar measurements. From the research provided, the majority of the student nurses who participated in the survey gave similar responses.

In giving a professional judgment and opinion of the paper, I will consider the abstract of the research, the literature review, and the research design. In addition, I will look into the methods of data analysis, the discussion, and the conclusion of the research.

The title of the study is brief and informative. At the first glance of the title, the reader can tell what to expect in the research project. The abstract provides a succinct summary of the contents of the paper. The research authors start by explaining the significance of the study. They adhered to the number of words recommended for a descriptive abstract which is between 75-150 words (Tullu, 2019). I considered this as an excellent abstract as it clearly explains the purpose of the paper, and gives reasons as to why the research was carried out. From the abstract, one can immediately deduce the accomplishments and conclusions of the research.

The introduction of the study is quite impressive and reflects that of a typical research paper. In this part, the research authors give a brief overview of the research title and the background of the study. The research problem is properly defined and discussed in this section. From the introduction, a reader gets the idea that the problem addressed in the paper is researchable. One gets a firm sense of what was done in the study, why the issue of hand hygiene is of interest, and the rationale of the research. The research authors restate the general objectives of the study and the specific question that the paper seeks to address.

The literature review done by the research authors is not satisfactory enough. They gave an overview of the available literature which touches on the problem being addressed in the study. However, the literature review done is too short and does not provide enough information to the reader. There is no clear identification of studies and models that support the study topic. A good literature review should provide the reader with a broad overview of the existing literature and critically analyze its strengths and limitations (Bolderston, 2008). The authors did not address this issue in the study. It would have been advisable for the research authors to have a literature review-only section in the study. They however mixed the discussion of the research findings and the literature review. A reader may have a hard time differentiating between the literature review and discussion of the study findings in such a case.

The research design was properly structured. There is a clear explanation of what the researchers did and how they did it. For instance, the research authors broadly explain the criteria used to select survey respondents and administer questionnaires. This allows the reader to evaluate the validity and reliability of the study results. The number of survey participants and their mode of selection is clearly stated. The research authors describe the apparatus they used to engage respondents and collect their responses. There is a clear explanation of the process the researchers used to comply with the ethics requirements of research.

The research authors used various methods to make a proper data analysis. A section of the paper provides the reader with a summary of the data collected, results, and findings of the research. From the section, one can easily deduce how the authors arrived at the conclusions. The results of the study are briefly explained and outside literature is used to support the arguments. The data analysis in the study is sufficient to substantiate the claims made by the research authors. The use of bar charts makes the analysis simpler and clearer for the reader to comprehend. In addition, every data obtained from the survey was taken into account during the analysis process.

The discussion of the study findings is well structured. The relevant implications of the study are properly evaluated and interpreted in relation to the original research question. There is a harmonious correlation between the study findings and the theoretical framework. Under this section, the research authors provide clear statements of support to the original research hypothesis. In addition to discussing the results of their study, the authors went ahead to discuss other outside studies related to the research question. All the work sourced from outside materials was well referenced. The research authors have compiled a list of all the references used in the preparation of the study. There are no repetitions of points that have been discussed in other sections of the research paper. Research authors recognize the need for improvements and further research on the same topic.

The conclusion of the research did not summarize all the main points addressed in the study. However, the research authors used this section to emphasize the need for conducting further research. The usefulness of the research is stated but the details are scanty. The thesis of the study is restated in the conclusion part and different words as per the guidelines of a good conclusion in a study (Gray, 2019). The research authors would, however, have done more to relate the key arguments with their contribution to the thesis of the paper. There were no new ideas introduced in the conclusion. Even though the part is brief, a reader can understand what the research is about by reading the conclusion section of the research paper.

By looking at the strengths and weaknesses of the paper provided, I am convinced that it reflects a typical research paper. The research authors promote a problem-solving approach based on evidence in healthcare delivery. The research work is a step towards the integration of the best evidence from studies and actual clinical patient care. There are efforts by the research authors to equip student nurses with the knowledge and the skills that they require to implement evidence-based practice consistently. I would recommend this study to all nurse students and curriculum developers. The student nurses can use the study to improve their knowledge in hand hygiene while curriculum developers can use it to restructure the learning materials of undergraduate nurse students.

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References

Bolderston, A., 2008. Writing an Effective Literature Review. Journal of Medical Imaging and Radiation Sciences, 39(2), pp.86-92.

Chou, D., Achan, P. and Ramachandran, M., 2012. The World Health Organization ‘5 Moments of Hand Hygiene. The Journal of Bone and Joint Surgery. British volume, 94-B(4), pp.441-445.

Gray, J., 2019. Discussion and conclusion. AME Medical Journal, 4, pp.26-26.

Jones, T., Baxter, M., and Khanduja, V., 2013. A quick guide to survey research. The Annals of The Royal College of Surgeons of England, 95(1), pp.5-7.

Kaur, P., Stoltzfus, J. and Yellapu, V., 2018. Descriptive statistics. International Journal of Academic Medicine, 4(1), p.60.

Schmidt, T., Gazou, A., Rieß, A., Rieß, O., Grundmann-Hauser, K., Falb, R., Schadeck, M., Heinrich, T., Abeditashi, M., Schmidt, J., Mau-Holzmann, U. and Schnabel, K., 2020. The impact of an audience response system on a summative assessment, a controlled field study. BMC Medical Education, 20(1).

Schoonenboom, J. and Johnson, R., 2017. How to Construct a Mixed Methods Research Design. KZfSS Kölner Zeitschrift für Soziologie und Sozialpsychologie, 69(S2), pp.107-131.

Tullu, M., 2019. Writing the title and abstract for a research paper: Being concise, precise, and meticulous is the key. Saudi Journal of Anaesthesia, 13(5), p.12.