Evidence to Develop Infection Prevention Practices

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Table of Contents

Introduction
Visual Reminders to Wash Hands
Audio-visual stimulation
Findings from Articles
Relevance of Findings from Articles
Conclusion
References

Introduction

Healthcare workers need to utilize evidence-based research findings to prevent the spread of pathogens in the hospital. Nurses can use the Population/Patient, Intervention, Comparison, Outcome, and Time (PICO(T)) framework to establish safety strategies for minimizing infections. The objective of the current paper is to utilize secondary papers in explaining the role of hand hygiene for healthcare visitors in infection control. The sources are essential for determining if technology to remind hospital guests about hand washing will improve the practice and result in a lesser spread of disease. The discussion will include the rationale for choosing each of the research and the relevance of crucial findings use of the PICO(T) Framework in Healthcare Visitors Hand Hygiene.

Dirty hands promote the spread of pathogens and increase hospital inquired infections. Notably, there has been more emphasis on nurses and other professionals working in the hospitals to develop a culture of washing their hands before and after handling a patient (Lary et al., 2019). However, cases of non-compliance are still numerous among other people, such as friends and relatives, who visit hospitalized patients. Various modern technology strategies can help promote hand washing among such guests. Thus, the study question is: Among people who visit healthcare centers (P), does the use of technology to create awareness of the importance of hand hygiene (I), instead of assuming that they understand (C), resulting in frequent and consistent hand washing (0)?

The first intervention is using technology with visual stimuli reminding visitors that they need to clean their hands. For example, this can be in the form of a camera pointing towards the tap or videos on the phone showing the importance of maintaining hand hygiene. The other intervention was audio-visual messages that educate and remind the people to comply with the hospital’s standards for cleaning their hands.

Visual Reminders to Wash Hands

Sight is a powerful sense which can help people to remember essential things. Some researchers in the selected studies used visual reminders to make the hospital visitors comply with hand washing policy. In one study, the researchers displayed signs of reciprocity, liking, authority, consistency, reciprocity, and scarcity on-screen, placed just above the hand rub dispenser (Guabe et al., 2020). Similarly, another research utilizes a motion sensor technology with a screen displaying different smiley emojis and images depending on whether the visitor bypasses or use the sanitizer (Guabe et al. 2018). For example, the image would change from neutral flower to either a sharp looking eye or smile depending on the behavior of the person. Lary et al. (2019), used video on the visitors’ mobile phones as an intervention. Overall, the visuals are intended to remind and commend those who sanitize their hands.

Audio-visual stimulation

Some researchers opted to combine audio and visual stimulation to ensure that the visitors had a reminder to adhere to the hand hygiene requirements. For instance, the intervention in one of the studies used a motion-sensor speaker that announced, “just a moment! Use the hand sanitizer before entering the ward” (Kim & Lee, 2019). The video and the sound were both directing the visitors to clean their hands just before entering the ward. Moreover, strategies like having someone at the door to observe and remind some of the people to wash hands are effective (Livorsi et al., 2018). The combination of visual cues and auditory messages utilize two common senses. Therefore, the chances of someone misunderstanding or misinterpreting the information are minimal.

Findings from Articles

The intervention strategies are highly effective in enhancing compliance with the hand washing requirements among the visitors. Findings from one of the studies established that there was a 24.4% increase in the number of people using sanitizers after the video messages (Lary et al., 2019). The change resulted in 50.8% of visitors complying with the hand hygiene policies of the hospital (Lary et al., 2019). Evidently, very few individuals who come to visit patients ever wash their hands consistently, hence, the need for the reminders. Some visuals, such as those depicting authority and social proof principles, are more effective in making more visitors adhere to hand washing standards (Guabe et al., 2020). Moreover, the use of emotion images had a significant contribution to the hand hygiene of hospital visitors (Guabe et al., 2019). Therefore, the message provided through the visual technology should be persuasive.

Similarly, the audio-visual interventions significantly impacted the behavior of visitors washing their hands while entering the hospital. Specifically, at the begging of the intervention, the number of non-family and family visitors was 1.5% and 0.0%, respectively (Kim & Lee, 2019). Intervention through visual stimulus increased the percentage to 5.4% and 0.6%, while audio-visual to 8.2% and 1.8%, respectively (Kim & Lee, 2019). The findings indicate that adding audio messages to the visual cues leads to more people cleaning their hands.

Technology makes work more efficient and significantly saves time due to automation. In one study where humans (auditors and observers) were used, the reports show that the surveillance exercise was ineffective due to the Hawthorne effect and getting tired (Livorsi et al., 2018). Moreover, there were less staff to assign some the task of checking whether all the visitors comply with the handwashing demands. Therefore, investing in technologies such as cameras, motion sensors, and screen is more effective in improving visitor compliance.

Relevance of Findings from Articles

All the articles used in an attempt to answer the PICO question are peer-reviewed and published in credible journals. The implication is that the findings are credible and reliable for use in changing clinical practice. The rationale for choosing the study by Kim & Lee (2019), is that it gives a comparison of when visual intervention is used solely versus audio-visual. The result can help the hospital management know which technology to invest in for better results. Livorsi et al. (2018) paper is good in pointing out the limitations of human labor. It helps to appreciate the technologies which are automated and non-biased compared to people.

Knowing the right message to relay for optimal results is important. The study by Gaube et al. (2020) provides information on how the structure of the message influences persuasiveness. Similarly, Gaube’s (2018) article is relevant in giving the idea of using face emotions in influencing hand washing behavior among visitors. All the articles contributed to answering the question of whether the use of technology to relay messages on hand washing can lead to positive behavior change.

Conclusion

Handwashing is essential in preventing the spread of bacteria that cause infections in the hospital setting. Yet, most people who come to visit a patient in healthcare organizations rarely comply with the handwashing demands. Reminder messages using technologies can help remind such people the need to wash hands when visiting their loved ones. Findings show that both visual and audio-visual stimuli are effective but the later offers better results. Thus, the preventive measure is effective and can be adopted as an evidence-based practice.

References

Gaube, S., Fischer, P., Windl, V., & Lermer, E. (2020). The effect of persuasive messages on hospital visitors’ hand hygiene behavior. Health Psychology, 39(6), 471-481.

Gaube, S., Tsivrikos, D., Dollinger, D., & Lermer, E. (2018). How a Smiley protects health: A pilot intervention to improve hand hygiene in hospitals by activating injunctive norms through emoticons. PLOS ONE, 13(5), 1-16.

Kim, D., & Lee, O. (2019). Effects of audio-visual stimulation on hand hygiene compliance among family and non-family visitors of pediatric wards: A quasi-experimental pre-post intervention study. Journal of Pediatric Nursing, 46(1), e92-e97.

Lary, D., Calvert, A., Nerlich, B., Segal, J., Vaughan, N., Randle, J., & Hardie, K. R. (2019). Improving children’s and their visitors’ hand hygiene compliance. Journal of Infection Prevention, 21(2), 60-67.

Livorsi, D. J., Goedken, C. C., Sauder, M., Vander Weg, M. W., Perencevich, E. N., & Reisinger, H. S. (2018). Evaluation of barriers to audit-and-Feedback programs that used direct observation of hand hygiene compliance. JAMA Network Open, 1(6), 1-26.

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