The purpose of the study was to establish whether the location of sinks available for health care workers to wash hands after attending to Clostridium difficile infection patients affects the level of hand hygiene compliance. The study further explored the link between the location of the sink and the compliance among health care workers with hand washing.
The study does not include any theoretical framework. The design was an observational cross-sectional study, which was performed at the Jewish General Hospital, Montreal, Canada. The investigation was done on 15 wards of the 637-bed, tertiary health facility. The observational study allowed the researchers to collect data over an extended period, observing hand hygiene practices.
Survey of sinks is one of the measures in the study to establish the number available to the health care workers to wash their hands after contact with CDI. An auditor measured the distance between the sink and the patient zone. Besides, handwashing compliance audits were done; surveys performed as a usual standard mandated by Accreditation Canada.
The research was conducted by auditors, who collected and recorded data for analysis. They recorded data regarding the location of the sink and the distance between sinks and patient zone. They also collected and recorded data through observation to establish the level of handwash hygiene.
The Strengths and Weaknesses of the Study
The study is the first to identify the barriers and enablers of compliance with hand wash hygiene after contact with CDI patients. The results of the study are consistent with previous findings, which indicated that the location of the sink determines the level of compliance with hand hygiene as an infection prevention strategy. Besides, the study used a relevant methodology to collect data to answer the research question, “how the location of the sink affects hand hygiene compliance among health care workers after contact with CDI patients.” However, the study had some weaknesses, such as a limited sample size, which affected generalization. The researchers conducted the study in a single institution, which affected the level of observations. Besides, they failed to design their inquiry to determine whether increasing the availability of sinks will improve the level of compliance. The limitations point to the need for additional exploration to research more aspects of hand hygiene compliance among health care workers through sink location and availability.
The Logical Links of the Steps of the Research Process in the Article
The problem statement was the prevalence of hospital-acquired infections that inform the need for hand hygiene compliance. The significance of the study was to fill the gap in research about the effect of the location of the sink on hand hygiene compliance among health care workers after contact with Clostridium difficile infection (CDI) patients. Although research in this area is limited, the researchers reviewed studies relevant to the topic of hang hygiene in controlling hospital-acquired infections. Recent research proves that hand hygiene is effective in preventing such diseases. The article does not have a theoretical framework before the presentation of the review of the literature. It lacks a theory to support the methodology of the study. Although the survey lacks a framework, Deyneko et al. (2016) identified research objective, which was to evaluate how the location of the sink available for health care workers affects their handwashing compliance. While the study identifies primary variables, sink location and hand hygiene compliance, it lacks uncontrolled extraneous variables. The researchers operationalized the variables through audits of sink locations and handwashing practices in a 637-bed tertiary care hospital, Canada.
The study used observational cross-sectional to collect data. The design was appropriate for the research because it allowed data collection through observation over some time, especially to observe hand hygiene compliance. Various threats to the validity of the design were evident, such as selection bias and sample limitation because data was collected data from a single institution and potential changes in the conditions of the hospital throughout the study, such as changes in the health care workers.
Deyneko et al. (2016) conducted the study in a single institution, a 637-bed tertiary care hospital, Canada. The potential bias was the selection of a single hospital, which might not be representative of other facilities. The sample was insufficient, and the researchers failed to use power analysis to determine sample size. The Jewish General Hospital Institutional Review Board approved the research, but it lacks an indication of respect for the rights of human subjects. Besides, the study lacks generalization conditions. The study used sink audits and hand hygiene compliance audits to measure the two variables. The indication of the sufficiency of the instruments to detect small differences between subjects is also lacking. The instrument validity and reliability are adequate because previous studies provided evidence.
The Quality of the Study
The quality of the study is evident because of the use of a reliable methodology and measurements to test the variables. Although the review was first to examine the relationship between sink location and hand hygiene compliance among health care workers after contact with CDI patients, it provides strong evidence of the association. The research offers reliable evidence about the predictors of hand hygiene compliance. Findings indicated a positive relationship between the two variables, pointing to a need for mitigating strategies to improve patient safety by preventing hospital-acquired infections.