handwashing practice among the health care workers in a teaching hospital

 handwashing practice among the health care workers in a teaching hospital

The topic of the study is on handwashing practice among the health care workers in a teaching hospital. The article systematically analyses the health care-associated infections. The author argues that healthcare-associated infections are one of the significant challenges of modern medicine, and they remain to be a substantial health concern around the continent. The hands of the health care workers are the critical point of transmission of pathogenic within the healthcare environment. From this, the author decided to conduct a research on the behavior of medics on hand washing. The study aimed at identifying if handwashing among healthcare workers reduces hospital acquired infections. Also, it focused on how often healthcare workers wash their hands. Also, the study aimed at identifying which category of the health workers washes their hands frequently to avoid transmission of pathogens within the healthcare environment. The research was conducted at Kathmandu in a non-government tertiary care teaching hospital. The author used a descriptive cross-section design while doing the research. The study found out that the nursing students and the nurses are the workers who observe hand washing practices more compared to other workers. Also, the research found out that there are factors that determine the washing hand practices such as workload, a condition faced, and distance of the soap and washing point. Finally, the author concludes that the healthcare workers understand the importance of hand washing but they tend to do it selectively depending on the condition that they are handling.

The study used a descriptive design approach. The reason behind using descriptive approach is that the study aims at answering the what, why and how of the problem under the study. The authors also used both quantitative and qualitative research approaches to collect data from the respondent through the use of a well-structured questionnaire using the World Health Organization (WHO) hand hygiene. The quantitative approach focuses on objective measurement and use of statistics, mathematical or numerical analysis of the data collected using the selected instrument of data collection. On the other side, a qualitative approach focuses on obtaining data through open-ended and one on one conversation. It gives space for the respondent to provide their views and share their feelings towards the topic of study.

Population specification is a requirement in the guiding of any research study. The population influences the credibility of the research based on the researcher’s understanding, definition, and choice of it. The article focused on health workers in Kathmandu medical college teaching hospital. A sample size of 336 was obtained through a quota sampling technique. The quota sampling is obtained through grouping the target population into groups by use of common traits, and a sample is obtained from each group to achieve a quota.

Questionnaires were the main instrument of data collection. Questionnaires are research instruments that consist of a series of questions to get information from respondents (Abawi, 2017). Both open-ended and closed questions were used to obtain the required information. Questionnaires are appropriate for studies because they collect information that is not directly observable as they can inquire about feelings, motivations, attitudes, accomplishments, as well as experiences of the respondents. The other benefit of using this instrument is that it is cheap and fast to administer; therefore, saving on both time and resources. Open-ended questionnaires provided the respondents with an opportunity to present their personal opinion that may be beyond the researcher’s knowledge. The respondent was conducted on a voluntary bases.

The researcher conducted a pilot text on twenty medical personnel before the study. A pilot test is always conducted to test the validity and reliability of the data collected using the questionnaire. The primary aim for any pre-testing is to identify and correct inconsistencies arising from the instrument, which ensures that they measure what is intended.  Before conducting the real study, the author got ethical approval for the study from the Nepal Health Research Council (NHRC) Ethical Review Board. After obtaining ethical consent, the authors proceeded to the area where they gathered the data. They issued out the questionnaires to the quotably selected health workers according to the different categories identified. After collecting the filled questionnaires, they had the needed data for analysis and presentation. The article used Microsoft excel 2007 to record the data obtained and used Statistical Package for Social Sciences (SPSS) version 16.0 to analyze the data.

From the review, it can be observed that nursing student and nurses wash their hands from time to time. They do this in case they are exposed to any hospital instrument, blood, or other body fluid. Also, the nurses have shown a high self-responsibility in observing hygiene since they wash their hands immediately after blowing nose, sneezing, or coughing into their hands. It shows that nurses are the pioneers of maintaining high cleanliness in the health care environment. In reality, nurses are trained to safely and sustain the life of human beings and also to give hope to persons who have already lost hope in life. They should always acts as the engine that drives the health care sector in the global. Therefore, from this, nurses are required to avoid any activity that may pose a threat to them and the people that they handle in their daily activities either in professional work or in none professional work.  Nurses are trained to be and are also required to be the most responsible beings under the planet since their nature of work is highly risky and needs a lot of concentration. As a result of this, these people tend to observe the highest level of hygiene since that one way of being responsible.

The nurses offer nursing services to the patient that they handle. Therefore, this shows that the nurses are the closest people to the patient who displays different conditions. Also, due to the nature of their work, nurses tend to handle the most significant tasks in a health care center. They always deal with a lot of equipment, of which some may be exposing their bodies and that of their clients into more significant dangers in case they ware not well handled. So, one can conclude that ‘care’ is one of the critical drivers of a nurse while performing his/her duty. Due to this, they are always expected to display the highest level of concentration and keenness. From the finding of the article on the study, it is clear that the nurses and the nursing students are meeting their professional expectations. The reason behind this is that the nurses are keen on washing their hands in order to avoid the transmission of various pathogens.

As nurses, we are always exposed to a lot of dangers of contracting various pathogens either through the patient we handle or through the equipment that we deal with, as explained earlier. To avoid these dangers, we are always expected to sterilize our hands or even wash them by the use of various detergents. As it’s said, “involve me, and I will never forget,” this phrase applies a lot in nursing school since the tutors always involve us in personal hygiene activities by reminding us of the importance of washing our hands before and after handling any client. Also, back home, many nurses are told to wash their hands and time take a bath before they deal with anything after their professional work. These practices have built a culture in nurses, and that why they take hand washing activity very keenly.

The other healthcare workers, such as doctors and medical students, are less keen on washing their hands. In my view, the review they fail to wash their hands frequently, mostly due to their nature of work. In many cases, these workers don’t handle a lot of clients at a time, and they use less equipment, and in many cases, these equipment are dealt with by the nurse assisting them. Therefore, they may have failed to develop a hand washing culture since they feel that they aren’t exposed to many pathogens as the nurses. Also, it may be as a result of the negligence of observing good hygiene with the health care environment.

Therefore, from my overview, the view of the article matches my overview expectations. It’s a belief that nurses should be on the frontline in maintaining proper hygiene. By doing this, they will have to meet the expectation of their professional and that of the community. Also, it is expected that nurses are keen on what they do and what they are told; thus, they should be sharp in washing their hands while at the health care centers since that one is of emphasis by the tutors. So from the findings in this article the nurses have meet the expectations and it is encouraging since all patient will feel safe when under any nurse around the area of study.

The outcome of the topic under the study is that 330 participants (98.5%) agreed that hand washing could be a useful measure in preventing health care-associated infections. However, the number of health workers that used the provided hand hygiene products was only 294 (87.5%) of the total sample population. Also, in many healthcare services soap bar was available as a form of hand hygiene product followed by liquid hand wash. However, the bacterial population difference between the bar soap and liquid soaps was statistically significant (p=0.005). Some of the studies that the authors of this journal have reviewed indicate that there has been an increase in compliance of hand hygiene after the introduction of alcohol-based hand sanitizers in health care settings more so in high demand conditions and crowded areas of hospitals especially in outpatient departments and inwards. Therefore, this shows that availability of easy way of washing hands may increase the level of hand hygiene in heath care centers. However, these alcohol based sanitizers are only available in few hospitals- 4.2%.

There was a significant difference in hand washing practices among the participants (p<0.001). The nursing students recorded the highest level of hand washing practice both before and after examining the client. The nurses followed them, and the lowest was the medical students (p<0.001). The difference in workload, accessibility to soap dispensers and hand washing stations, irritation, and dryness of the hand brings about the difference in hand washing practices. There was an increment in hand washing practice in all groups after exposure to hospital instruments, blood, or any other fluid. This was the case after sneezing, blowing the nose, or coughing apart from nurses and nursing students who seemed reluctant to wash their hands compared to practice after the patient examination. From this, one can observe that despite healthcare workers understanding the importance of hand washing they will tend to wash their hands selectively depending on the condition exposed to them in their practices.

Validity is the degree by which the sample of test items represents the content the test is designed to measure. Content validity, which this study employs to, is a measure of the degree to which data collected using a particular instrument represents a specific domain or content of a specific concept. From the study, it is observed that the researcher’s content was not valid. The authors evaluated a new survey instrument to ensure that it consists of all the necessary items. However, the researcher lacked a literature review of the study of which is an essential aspect of content validity. Also, for content to be varied, a content validity survey should be generated, and the use of three point scale should assess each item. The article lacks Content Validity Ratio (CVR), which should be calculated by the use of Lawshe’s (1975)’s method. However, he has been able to eliminate undesirable content to a particular content domain since everything in the article is related to the topic of study.

Reliability refers to the consistency of measurement, and it is assessed frequently using the test-retest reliability method. Reliability is increased by including many similar items on a measure, by testing a diverse sample of individuals and by using uniform testing procedures. It is always essential to test the reliability of the study since it always refers to consistency across the parts of the measuring tool. The commonly used internal consistency measure is the Cronbach Alpha co-efficiency. It is suggested that for reliability to be considered appropriate, it should be equal or more than 0.60.  This journal lacks the Cronbach alpha co-efficiency; thus, the author failed to test for the reliability of the content collected. Therefore, the study lacked validity and reliability.

Bias is an intention or unintentional favoring of one group or a specific outcome over the other potential groups or results in the population of the study. The study doesn’t have any bias in its presentation and analyses of the result. The reason behind this is that the researchers have used an appropriate research design approach. Quota sampling technique was well used since the study has got different categories of the target population, and each group expresses different characteristics from each other. Since the selection was based on the number of individuals in a particular group them this method of sampling helped them to avoid biasness, which could have occurred if another sampling was to be applied.

While analyzing the results, the researchers decided to investigate the groups differently, and they presented the data in the form of a quantitative approach through the use of a percentage. After doing quantitative analysis, the results were compared to each other, and conclusions on the topic of the study were drawn from their differences. Through this, it helped the researchers to avoid bias that could have occurred while discussing the outcomes of the findings. From this, one can conclude that the research was conducted well, and the researcher used the best approaches to avoid biases.

For any research to be acceptable, the researcher should provide evidence to support his or her research. Authors do this by providing facts behind their findings and conclusions, although this works best in experimental analyses. From the overview of the article o study, one can observe that the researcher provided evidence from other scholars who had conducted similar research. The researcher acknowledges research conducted at India in the Emergency department that had similar findings that nurses wash hands more often than any other staff physician or resident physicians. Also, he gives another evidence of a study conducted by Pittet at a teaching hospital in Geneva that indicated that none compliance for hand washing was more significant among the physicians and other health workers than that of nurses.  These are some of the few pieces of evidence among many others in the article. Therefore, from this, it is evident that there is significant evidence on the review.