Rough Draft Qualitative Research Critique and Ethical Considerations

Rough Draft Qualitative Research Critique and Ethical Considerations

Research Critique

Hospital-acquired infections are considered contaminations that are not present during patient admittance to the healthcare settings but occur during treatment and care. Hospital-acquired infections are common challenges and problems that have been encountered by all healthcare facilities globally. The aspect of nursing practice has been linked to the increase and decrease of hospital-acquired hospital infections. This paper will focus on two qualitative studies with findings used in nursing practice to reduce hospital-acquired infections.

Background of Study

Ghaffari et al., (2020) aimed at determining the facts that influence the hand hygiene of the nursing staff. Ideally, hand hygiene is one of the simplest ways to reduce hospital-acquired infections to boost patient security and eliminate the spread of antimicrobial resistance. However, hand hygiene compliance has been low among nurses, thus increasing hospital-associated infections that result in longer hospital stays and high healthcare costs. There are several barriers to hand hygiene, such as lack of hand hygiene facilities, skin irritation, and unawareness of guidelines, absentmindedness, wearing gloves, and work overload. Hand hygiene stands in the front line of controlling the infections and improving the clinical behavior of the nurses, thus increasing the priority need for hand hygiene in the nursing practice. The purpose of this research was to examine the various aspects of hand hygiene among nursing staff. The study’s objective was to present research on the elements of hand hygiene amongst nurses in hospitals. Therefore, the research question for this study was: What factors influence the nursing staff’s hand hygiene conduct in healthcare facilities?

Another study by Chatfield et al., (2016) focused on acute nurses’ experiences concerning hand hygiene. Considerably, health acquired infections have been linked with direct and indirect costs. For instance, the World Health Organization states that Hospital-acquired infections have accounted for annual direct costs of about 6 billion dollars in the U.S and 7 billion Euros in the EU. Some of the specific consequences of health acquired infections include readmission, discomfort, disability, length of stay in hospitals, and emotional stress to family members and caregivers. Hand hygiene has been considered a complex approach and behavior that greatly lowers the incidence of Hospital-acquired infections. This study has offered a solution to nurses by offering a modifiable factor, hand hygiene, that offers behavioral change interventions. This study aimed to examine the experiences of hand hygiene among nurses as a behavior change intervention. The study’s objective was to investigate the personal perceptions on hand hygiene to improve subjective interpretations and influence the responses to communication, policies, and education-based interventions for hand hygiene. The research question was on the experiences of nurses with hand hygiene.

PICOT Question

The PICOT question was; in healthcare settings, do hand hygiene protocols compared to gloves among nurses reduce healthcare-acquired infections? Generally, both studies have been used to answer the picot question. Ghaffari et al., (2020) have presented the determinants of hand hygiene and how they rate Hospital-acquired infections, while Chatfield et al., (2016) has focused on the nurses’ experiences to offer knowledge on hand hygiene interventions. The comparison group consists of nurses within different healthcare settings. The hand hygiene intervention discussed in both studies and the PICOT question focuses on nurses who have been used to examine the importance of handwashing and sanitization to prevent the spread of infections. Considerably, compliance with the hand hygiene procedures and guidelines is essential in controlling and preventing hospital-associated infections.

Method of Study

Ghaffari et al., (2020) conducted a qualitative study through a content analysis tactic. The study relied on 16-in-depth semi-structured interviews with the nursing workforce of Shariati Hospital of Tehran University of Medical sciences. Convenient sampling was conducted, and all interviews were conducted for 25-35 minutes in a private context. All the data was subsequently evaluated through directed qualitative content study based on the landsman and Graham method. Chatfield et al., (2016) also conducted a qualitative study with eight nurses employed in different patient care roles. The study relied on an interpretative phenomenological analysis method to examine how the nurses describe their lived familiarities with hand hygiene. The mean time for the interviews was around 56 minutes. The interviews were audio-recorded and transcribed before data analysis.

Semi-structured interviews are essential for open-ended responses from participants to acquire more in-depth information. The method allows the researchers to obtain open-ended data to explore feelings, thoughts, and beliefs about a certain topic. However, the limitation of a semi-structured interview is that it’s non-standardized since the respondents may be asked different questions. On the other hand, in-depth interviews are used to obtain a rich and more detailed understanding of the topic of interest. They allow the respondents to share their experiences and opinions without bias from other respondents.  However, the respondent can give misleading and limited answers, and the data cannot be generalized. Therefore, in-depth interviews are better compared to Semi-structured interviews. The interviewer has a list of topic questions in an in-depth interview and is more focused than the wide-ranging and general semi-structured.  They allow the respondents to communicate more freely and offer detailed descriptions as compared to the semi-structured interviews.

Results of Study

Chatfield et al. (2016) identified three super-ordinate themes: risky business, practical hygiene, and hygiene on trial. According to the participants, practical hygiene was obtained through water and soap, primarily through soap and sanitizer. The nurses described the work environment as a generally risky business due to a contaminated environment, which leads to hygiene challenges. In addition, the nurses described their understanding of rules and personal familiarity with hand hygiene. Regarding hygiene on trial, most nurses argued that 100% adherence to hand hygiene was unrealistic due to the conditions such as high workloads and low staff.

Ghaffari et al. (2020) revealed three major themes: attitude, perceived behavioral control, and subjective norms. Eight other themes were linked to hand hygiene: education, personality, environment, perceptions, salience, and organizational culture. Ghaffari et al., (2020) found out that all participants have a positive attitude towards hand hygiene. The participants mentioned that peer effect, doctor’s belief, and supervisors’ attention to hand washing are effective factors. Awareness and education are among the themes that promote hand hygiene behavior. The organizational culture, personality, and lifestyle have played a major role in hand washing.

The studies have acknowledged the significance of hand hygiene as an intervention that might encourage the reduction of Hospital-acquired infections. Hand hygiene is a great way of preventing infections since nurses must clean their hands to prevent the spread of hospital-associated infections.

Ethical Considerations

Among the ethical considerations in carrying out researches were confidentiality of data and informed consent. Informed consent entails the legal and ethical agreement for research through informing the participants about the major components of the research study. Confidentiality of data entails the researcher’s contract to store, manage and share the study data so that the data is limited to those authorized. Ghaffari et al., (2020) confirmed consent and confidentiality through voice recording and manual note-taking. Chatfield et al., (2016) confirmed consent through a written informed consent and signatures before the interview.

References

Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S. (2016). Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis. SAGE open medicine, 4, 2050312116675098.

Ghaffari, M., Rakhshanderou, S., Safari-Moradabadi, A., & Barkati, H. (2020). Exploring Determinants of Hand Hygiene among Hospital Nurses: A Qualitative Study.