Aim of assessment

Healthcare associated infections are also known as nosocomial infections which are acquired by a patient who is admitted to a particular health care setting, in order to receive care services for the management of other diseases or illnesses (Akinboyo et al., 2019). The signs and symptoms of nosocomial infections are generally reported by a patient within 48 hours of being admitted to a health care setting, or within few days after receiving the care interventions. These infections encompass the spread of pathogens or germs from an infected patient to a healthy patient, from healthcare staff to a healthy patient, or from family members to the patients. Nosocomial infection significantly contributes to high rates of morbidity and mortality worldwide, and has also been found responsible for an increase in the length of hospitalization for majority of the patients all across the globe. Failure to prevent the onset of nosocomial infection also increases the out of pocket expenditure for the patients who have been admitted to the care facilities (Li et al., 2017). Some of the most prevalent nosocomial infections are pneumonia, Clostridium difficile infection, catheter associated urinary tract infection or CAUTI, bloodstream infection, and surgical site infection (Russo et al., 2018). Surgical site infections typically occur when there is an entry of pathogen at a particular location on the skin surface of patients, where an incision had been made for a certain surgery. It has often been found that majority of the healthcare organisations all across the world place an emphasis on showing adherence to the six steps of hand hygiene, in order to decrease the rate of nosocomial infection and enhance patient health outcomes. The six steps of hand hygiene are namely, (i) rubbing palms in a circular motion, (ii) rubbing back of the hand, (iii) interlinking the fingers, (iv) cupping the fingers, (v) cleaning the thumbs, and (vi) rubbing palms using fingers (Arias et al., 2016).

The research will be based on a quantitative design due to the fact that it will help in drawing conclusions to the aforementioned referred question, with the use of computation and statistical procedure that provide a numerical representation of the findings. Conduction of a quantitative research will help in determining the presence of surgical site infection in a health care setting, in terms of its incidence that refers to its rate frequency or occurrence. This will play an important role in identification of the fact whether six steps of hand hygiene followed by the nursing professionals have been able to create any substantial impact on nosocomial infection (Goertzen, 2017).

Details

The findings obtained can be therefore generalized to a wider population, and will also facilitate establishment of a causal effect. The findings obtained from the quantitative research can be explained as confirming and predictive. Owing to the fact that it would consist of data collection such that the information can be quantified, the primary and secondary outcomes will be eventually subjected to statistical treatment that will help in refuting claims on alternate knowledge about nonsocial infections and hand washing protocol (Queirós, Faria & Almeida, 2017). The methodology followed in this quantitative research will be extremely easy to replicate by other investigators, therefore will increase reliability of the findings. 

Randomisation of the participants for this particular research will ensure that all nursing professionals working in the surgical setting of the particular hospital have the equal chance of being allocated to either the intervention of the control group, thus preventing any kind of selection bias (Patten & Newhart, 2017). The intervention that would focus on compliance to six steps of handwashing will be directly compared to normal infection control procedures that are followed by the nursing professional, which in turn will facilitate establishment of superiority of one treatment over another. A prospective design will help in decreasing recall error. In addition, randomisation will also help in reducing confounding, which can be accredited to the unequal prognostic factor distribution. Furthermore, it will also help in avoiding type 2 error (incorrect acceptance of null hypothesis) or type 1 error (incorrect rejection of null hypothesis).

Recruitment of the nursing professionals for the randomised control trial will be based on convenience sampling that is a non-probability sampling technique involving study subjects from a population based on its proximity to the researcher. Convenience sampling will be selected for this particular study owing to the fact that the comparative time and expenditure required for recruiting a convenience sample is small, in contrast to other techniques of probability sampling. This will play an important role in accomplishing the sample size required, in a comparatively inexpensive and rapid manner (Etikan, Musa & Alkassim, 2016).

In addition the sampling procedure has been found effective in recruitment of research participants who are generally reluctant to disclose information on certain issues. Taking into consideration the fact that research will focus on adherence to six steps of handwashing by nursing professionals, following any other sampling procedure might make the nursing staff hesitant to divulge about their compliance to appropriate infection control procedure that creates a direct impact on patient health and safety (Hu & Qin, 2018). 

For Nursing students only

Inclusion criteria for recruitment of the research participants will be as follows: (i) nursing professionals having appropriate licence and registration, (ii) experience of at least one year in surgical setting, (iii) currently looking after patients in the surgical ward, (iv) adequate English language proficiency, (v) adequate cognition and state of mind in order to understand the hand washing protocol, and (vi) absence of any infection or communicable disease at the time of conducting the research.

Nursing staff who do not have registration, work in other settings of the hospital such as, emergency department, outpatient clinic, psychiatric ward or ICU, or those who are not proficient in English will not be considered eligible for the study. Data collection will involve a clinical audit that will help in calculating the rates of surgical site infection, blood stream associated infection and CAUTI in the surgical ward, before and after the trial, thus providing a definite conclusion to the research question. Self-reported questionnaires will also be distributed to the nursing staff to determine their adherence to the infection control practice, thus providing an overview of their attitudes and perception towards infection control.

Descriptive statistics will be conducted in this randomised control trial due to the fact that if the collected raw data are simply presented, it will be difficult to visualise what the data intends to represent, particularly when there are lots of information, in relation to the primary and secondary outcomes (Holcomb, 2016). Therefore, conduction of a descriptive statistical analysis will enable presentation of data in a meaningful manner, thereby facilitating simple data interpretation. In contrast, inferential statistics will play a significant role in generalizing the research findings to a wider population. It will not only facilitate determining what can happen if the nursing professionals show other into six steps of hand hygiene across all healthcare settings, but will also assist in evaluation of the strength of association between the causal variables (six steps of handwashing protocol) and the effect variables (rate of surgical site infection) (Amrhein, Trafimow & Greenland, 2019).

The SPSS 21.0 version software will be used while computing the results in a statistical format. The aforementioned software comprises of several tools such as, open source extensibility, machine learning algorithm, and text analysis that play an important role in evaluating research findings in a numerical method (Green & Salkind, 2016). The software will therefore prove imperative in determining whether the six steps of handwashing protocol helps in increasing or decreasing the total number of nosocomial infections in the surgical ward of the particular hospital. A numerical representation of the incidence of bloodstream associated infections, CAUTI, and surgical site infection will show whether the findings of this research are consistent with those that formed the premise of the study that is rates of nosocomial infection in surgical settings can be prevented if the nurses appropriately follow the six steps of hand hygiene protocol. This will increase credibility and reliability of the findings, and will also help in paving the way for future research that need to be conducted across many other hospital and healthcare facilities.

References

Amrhein, V., Trafimow, D., & Greenland, S. (2019). Inferential statistics as descriptive statistics: There is no replication crisis if we don’t expect replication. The American Statistician, 73(sup1), 262-270. https://doi.org/10.1080/00031305.2018.1543137 

Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American journal of theoretical and applied statistics, 5(1), 1-4. https://www.researchgate.net/profile/Sumanta_Deb2/post/Purposive_Sampling_and_Convenience_Sampling_are_these_two_types_of_Sampling_different_Please_Explain/attachment/59d64fc179197b80779a8d1c/AS:[email protected]/download/Comparison_of_Convenience_Sampling_and_Purposive_S.pdf 

Goertzen, M. J. (2017). . Introduction to Quantitative Research and Data. Library Technology Reports, 53(4), 12-18. https://journals.ala.org/index.php/ltr/article/view/6325

Green, S. B., & Salkind, N. J. (2016). Using SPSS for Windows and Macintosh, books a la carte. Pearson. https://dl.acm.org/doi/book/10.5555/3066228

Holcomb, Z. C. (2016). Fundamentals of descriptive statistics. Routledge. https://books.google.co.in/books?hl=en&lr=&id=X18PDQAAQBAJ&oi=fnd&pg=PP5&dq=descriptive+statistics&ots=UTFqMpLZRc&sig=EuYwQP3tJbZWW-TH4bqRLGoVvC4&redir_esc=y#v=onepage&q=descriptive%20statistics&f=false

Hu, Z., & Qin, J. (2018). Generalizability of causal inference in observational studies under retrospective convenience sampling. Statistics in medicine, 37(19), 2874-2883. https://doi.org/10.1002/sim.7808

Patten, M. L., & Newhart, M. (2017). Understanding research methods: An overview of the essentials. Taylor & Francis. https://books.google.co.in/books?hl=en&lr=&id=YAoqDwAAQBAJ&oi=fnd&pg=PP1&dq=methods+of+research&ots=1fHyMWMrHw&sig=fvh0JKNMk8_RTa47sCp9X6IpVEs&redir_esc=y#v=onepage&q=methods%20of%20research&f=false

Queirós, A., Faria, D., & Almeida, F. (2017). Strengths and limitations of qualitative and quantitative research methods. European Journal of Education Studies. https://oapub.org/edu/index.php/ejes/article/view/1017