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WednesdayDec 20 at 1:54am Manage Discussion Entry The clinical issue of interest I will be focusing on is the effectiveness of hand hygiene monitoring systems in the prevention of hospital acquired infections (HAIs). The hands of healthcare personnel are the most frequent means by which pathogens linked to healthcare are spread among patients and across the hospital setting. The most effective way to stop the spread of antibiotic resistance and lower the number of infections linked to healthcare is to practice good hand hygiene (Allegranzi & Pittet, 2009). In evidence-based practice and research, the PICO(T) framework is a systematic method for developing clinical or research questions. PICO(T), an acronym for patient, intervention, comparison, outcome, and (sometimes) time, is derived from the components of a clinical research question. The query is formulated to elicit an answer, and the PICO(T) process starts with a case scenario (DUQUESNE UNIVERSITY, 2020). In clinical decision-making or research activities, this organized framework aids in the formulation of targeted and manageable queries, serving as a basis for efficient literature searches and evidence retrieval. Utilizing the PICO(T) framework for my proposed question would appear as follows; In healthcare workers, does the implementation of hand hygiene monitoring systems compared to standard hand hygiene practices without monitoring result in a reduction in the incidence of hospital-acquired infections over a one-year period? P (Patient/Population/Problem)- Healthcare workers I (Intervention)- Hand hygiene monitoring systems C (Comparison)- Standard hand hygiene practices without monitoring O (Outcome)- Reduction of HAI’s T (Time)- One year The first database I searched was PubMed. The initial search of the term “hand hygiene monitoring systems” returned approximately 382 results. To narrow down this search result into more usable and applicable data I used the Boolean operator. Nesting and Boolean operators facilitate the process of finding word or phrase combinations that have been processed in a particular order. Keyword searches are possible for the Boolean operators AND, OR, and NOT. Simply type these terms into the search field in Keyword Search (Library of Congress, n.d.). I added the word “infections” to the search and narrowed down the results to the past five years. This search narrowed the previous results to about half resulting in 162 results. To further narrow the results, I then added “hospital acquired infections” to the search thus bringing down my results to 24.

The second database I searched was CINAHL. The initial search of the term “hand hygiene monitoring systems” returned approximately 149 results. Next, I used Boolean operator to narrow the results. I again added the word “infections” to my search. Since this only narrowed it down to 123 results I took it one step further and narrowed it down to the past five years again to ensure I had the most recent and relevant results. My results after doing so narrowed down to 88 articles. For comparison purposes I again added the term “hospital acquired infections” as I had done in my previous database search with PubMed. My results for this search produced 42 usable articles. One can take into account the following tactics to improve the thoroughness and efficiency of a database search on PICO(T) question. Using synonyms and related terms. For example: when searching for “hand hygiene” include terms such as “handwashing” or “hand disinfection”. Searching by study type can be another tactic to improve results. Example: Use database filters or include terms like "randomized controlled trial" in your search if you are interested in particular study types (e.g., randomized controlled trials). It has been shown that the PICO(T) framework is a very useful tool for developing focused and accurate research questions when it is incorporated into the research process. PICO(T)'s organized elements—which include patient characteristics, therapies, comparisons, outcomes, and time frames— offer a methodical way to formulate questions that direct both research and evidence-based practice. References Allegranzi, B., & Pittet, D. (2009). Role of hand hygiene in healthcare- associated infection prevention. Journal of Hospital Infection , 73 (4), 305– 315. https://doi.org/10.1016/j.jhin.2009.04.019 Links to an external site. DUQUESNE UNIVERSITY. (2020, September 26). Formulating a PICOT Question . Duquesne University School of Nursing. https://onlinenursing.duq.edu/blog/formulating-a-picot-question/ Links to an external site. Library of Congress. (n.d.). Search/Browse Help - Boolean Operators and Nesting: LC Catalog (Library of Congress) . Catalog.loc.gov. Retrieved December 20, 2023, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html Links to an external site.

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