Capella 4030 Assessment 3 : PICO (T) Questions and an Evidence-Based Approach

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Capella University

Capella 4030 Assessment 3

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Description of the PICO(T) method

Hospitals worldwide face various healthcare issues which require extensive research to find evidence-based solutions. These issues may be directly related to patients for example acute and chronic diseases and adverse events related to health practices. Some of these issues can be indirectly related to patient care. One such issue will be discussed in this analysis by incorporating the easiest method of research called the PICO(T) approach. This approach helps healthcare professionals to improve their practices for improvising patients’ care and achieving desired health outcomes. 

This approach involves the creation of a PICO(T) question – P (patient/population), I (interventions), C (comparison with another element), O (outcome), and T (time frame – this is an optional component which is only used context-specific) (Brown, 2019). This approach helps to easily identify the information related to the topic by utilization of specific search terms. 

Practice Issue to be Explored

This paper explores one of the issues related to infection control where hand washing and hand sanitizing for nurses are always debated and hence require in-depth research to identify the best and most credible information to improve infection control practices among nurses. The PICO question that will be used to analyze this topic is: 

“In nurses working in the hospitals (P), does antibacterial sanitizers (I) helps in decreasing germs on hands (O) as much as hand washing with soap and water does? (C). 

According to the research, hand hygiene practices are essential for healthcare workers as their contaminated hands are the major source of infection for patients. Moreover, improper hand hygiene can help germs grow rapidly, thus increasing the risks of infections associated with hospitals, increasing patients’ length of stay, and ultimately causing severe complications (Alene et al., 2022). There is still controversy about the method that is most effective for hand hygiene among nurses and the internet is full of several pieces of information hence using a PICO question benefits healthcare professionals to use specific search terms so that only relevant and credible resources are found and used to improve the healthcare practices. 

Sources of Evidence – Hand Hygiene Practices

One of the important aspects related to the identification of the sources of evidence is to find credible resources so that all information that is used for evidence-based practices is relevant and trustworthy. According to the research, the CRAAP test is one of the most efficient criteria to evaluate the credibility and relevance of the sources. The components of CRAAP are currency, relevance, authority, accuracy, and purpose (Esparrago-Kalidas, 2021). The databases and journals which will be potentially effective to answer the PICO question are Google Scholar, PubMed Central, BioMed Central, CINAHL, MEDLINE, and Capella University’s Library. Whereas, the journals as sources of evidence are The American Journal of Infection Control (AJIC), Journal of Infection Prevention, and Infection Control and Hospital Epidemiology. These databases and journals are helpful to answer the PICO question created for this analysis as they are the most credible journals with high readability as well as are specific to the subject of research. 

Finding Articles – Relevant to Hand Hygiene Practices

Various studies have been conducted to identify the best practice between hand sanitization and hand washing for infection control by nurses and other healthcare workers. 

Relevant Findings from Various Articles

1. A literature review by Singh and colleagues (2020) concluded that hand rubs (sanitizers) can be efficient but their effectiveness depends on multiple factors the correct technique and amount of the product used, as well as the number of times they are used. Moreover, they cannot be applied to soiled hands where the bacterial count is high. The study further mentions that the most effective way to against bacteria is washing hands with soap and water (Singh et al., 2020). 
2. Another study that compares the efficacy of hand sanitizer and liquid soaps revealed that both of these interventions have similar results in terms of removing bacteria from the hands. Hence it was advised that either of the strategies can be used as per the availability of the resources (Anitha et al., 2020). 
3. Further study that examines the effectiveness of non-antimicrobial soap, antimicrobial soap, and alcohol hand rubs showed that all three helped reduce the bacteria however the highest reduction was observed after using hand rubs. Second was antimicrobial soap and the least effective was non-antimicrobial soap (Czaplicki et al., 2020). This resource is the most relevant and credible as it follows all the criteria of the CRAAP test. Currency (the article is published in 2020), relevance (it is relevant to the topic as it is a comparison between hand rubs and soaps), authority (the authors of the article are mentioned and the publication journal is one of the credible and relevant journals – Infection Control and Hospital Epidemiology), accuracy (all the claims are well justified), purpose (the purpose of the article is to measure the effectiveness of hand hygiene products). 

Decision-Making on PICO Question Related to the Findings

All the literature sources used above are credible and relevant to the topic of research “hand sanitization and hand washing – which is more effective?”. The findings provided information in favor of both interventions: hand rubs can be effective if used properly with appropriate technique and consistency but soap and water are easily available, help against soiled hands, and is cost-effective which is why it is more efficient (Singh et al., 2020). Furthermore, a certain type of soap (antimicrobial) has a high efficacy rate against bacteria (Czaplicki et al., 2020). On the other hand, studies have also revealed equal or more effectiveness of hand rubs against the bacteria thus improving hand hygiene practices (Czaplicki et al., 2020; Anitha et al., 2020). These pieces of evidence helped us research our PICO question by providing a conclusion that both of the interventions are effective for hand hygiene but the utilization should be based on certain factors like the amount of contamination on the hands, availability of the resources, and applying the rule of cost-effectiveness. 

Conclusion

In conclusion, to effectively research and find evidence-based practices for a healthcare issue a PICO(T) question can be used as a method to identify the sources of evidence using specific keywords so that relevant information is found. Furthermore, it is essential to use the standard criteria (CRAAP) developed to determine the credibility of the resources. These standard guidelines and methods help healthcare professionals to find evidence-based research that can be used to improve healthcare practices. 

References

Alene, M., Tamiru, D., Bazie, G. W., Mebratu, W., & Kebede, N. (2022). Hand hygiene compliance and its associated factors among health care providers in primary hospitals of Waghimira Zone, Northeast Ethiopia: A mixed study design. Antimicrobial Resistance & Infection Control, 11(1). https://doi.org/10.1186/s13756-022-01119-6 

Capella 4030 Assessment 3

Anitha, G., Khairnar, M. R., Dalvi, T. M., Kalghatgi, S., Datar, U. V., Wadgave, U., Shah, S., & Preet, L. (2020). Comparative efficacy of hand disinfection potential of hand sanitizer and liquid soap among dental students: A randomized controlled trial. Indian Journal of Critical Care Medicine, 24(5), 336–339. https://doi.org/10.5005/jp-journals-10071-23420 

Brown, D. (2019). A review of the PubMed Pico Tool: Using evidence-based practice in health education. Health Promotion Practice, 21(4), 496–498. https://doi.org/10.1177/1524839919893361 

Czaplicki, M., Attar, S., Green, K., & Leslie, R. (2020). Qualitative visual assessment of Hand Hygiene Product Effectiveness. Infection Control & Hospital Epidemiology, 41(S1). https://doi.org/10.1017/ice.2020.1120 

Esparrago-Kalidas, A. J. (2021). The effectiveness of the CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education. Retrieved March 9, 2023, from https://i-jte.org/index.php/journal/article/view/25

Singh, P., Potlia, I., Malhotra, S., Dubey, H., & Chauhan, H. (2020). Hand sanitizer an alternative to hand washing—a review of literature. Journal of Advanced Oral Research, 11(2), 137–142. https://doi.org/10.1177/2320206820939403 

Capella 4030 Assessment 3