Question 1.Extraction Table – can you help me create an extraction table by… 1.
Question 1.Extraction Table – can you help me create an extraction table by… 1. Extraction Table – can you help me create an extraction table by answer those below questions Purpose/aim of the study Sample – Who was included in the study? How many people were included? Design – What kind of research was undertaken? Method – Describe how was the research conducted? Key Findings – What were the key findings? This is a journal article Summary Background: Hand hygiene promotion for patient safety is a challenge worldwide, and local data are critical to tailor strategies to the setting. Methods: This is a cross-sectional study of nurses and physicians providing direct patient care in four hospitals in Hong Kong using an anonymous questionnaire survey. Cognitive factors related to hand hygiene and the perception of effective interventions promoting hand hygiene were assessed. Results: The overall response rate was 59.3%. Among respondents, 70% of the nurses and 49% of the physicians perceived that over 15% of patients would suffer from healthcare-associated infections. A total of 79% of the nurses and 68% of the physicians believed that more than 5% of patients would die as a result of healthcare-associated infection. A total of 60% of the nurses and 46% of the physicians acknowledged that over 75% of healthcare-associated infections could be prevented by optimal hand hygiene practices, although 36% of the nurses and 23% of the physicians claimed that six to ten hand cleansing times per hour would be necessary. Bivariate analysis showed significant differences between professionals in self-reported performance. A multivariate regression model revealed that perceived behavioral control and subjective norms were the most important factors associated with the nurses and physicians’ self-reported hand hygiene performance. However when gender was taken into account among professionals, subjective norms was the only consistent one. Conclusion: These results could be used as a tool to create goal-specific strategies for motivating hand hygiene amongst nurses and physicians in Hong Kong, with appropriate promotional interventions delivered to the different professional groups and specialties. Infection 2009; 37: 320-333 DOI 10.1007/s15010-009-8245-x Introduction Although hand hygiene is recognized as the core element to reduce healthcare-associated infections (HCAIs) and enhance patient safety [1, 2], it is still not consistently practiced, and reported adherence rates seldom exceed 40% [3, 4]. As patient safety is a crucial component of patient care, Hong Kong is actively promoting hand hygiene through its collaboration with the World Health Organization (WHO) First Global Patient Safety Challenge ”Clean Care is Safer Care” [5]. Yet promoting this simple act is a complex issue [4, 6, 7] given the large number and diversity of factors affecting adherence, which include gender, profession, workload, types of hand hygiene products, accessibility to supplies, and additional individual intrinsic factors [2-4, 6-18]. Successful hand hygiene promotion does not only rely upon the implementation of interventions, it also requires an improved understanding of healthcare workers’ perceptions of HCAIs and hand hygiene [15-18]. The objectives of this study were to identify local nurses’ and physicians’ perceptions of HCAIs and hand hygiene in Hong Kong and to determine variables that influence their hand hygiene behavior so as to tailor an effective promotional strategy to the setting. Methods The study was conducted in four acute hospitals with patient beds ranging from 700 to 1,400. Study settings were selected based on patient acuity and geographic location and included medicine, surgery, orthopedics, pediatric, intensive care, and accident and emergency wards. Using a cross-sectional study design, we invited nurses and physicians to complete an anonymous questionnaire which was distributed and collected at their workplace. This self-reported questionnaire (Appendix 1), which collects data on cognitive factors related to hand hygiene behavior, was constructed by the WHO and contains elements of social cognitive theories applied to health-related behaviors, notably the Theory of Planned Behavior. This theory postulates that a given behavior is precipitated by an intention, which is predicted directly by enabling variables of attitudes (feelings or affective regard for the behavior), perceived behavioral control (perceptions of having sufficient control to perform the behavior), and subjective norms (perception about whether the person important to him/her think the behavior should be performed). These enabling factors are in turn predicted by beliefs about outcomes of the behavior, control beliefs, and normative beliefs, respectively [19]. Among the questions, those of Section A-C address demographic characteristics and perception of HCAIs and hand hygiene, whereas those of Section D explore the respondents’ judgment of the effectiveness of promotion interventions, which is measured using a 7-point bipolar scale. Multi-item questions related to different types of care in Section E assess the self-reported hand cleansing performance and the perception in (1) effectiveness of cleansing hands (attitudes), (2) difficulty or ease to cleanse hands (perceived behavioral control), and (3) how much their superiors want them to cleanse their hands (subjective norms). The response to each item of the latter three variables (perception scores) is evaluated by a 7-point bipolar Likert-type scale with opposite answers at each end, whereas the outcome variable (self-reported hand cleansing performance) is measured with scale values ranging from 0% to 100% in 10% increments. The study was approved by the respective institutional ethics committees as a quality improvement project. Statistical Analysis Cronbach’s alpha coefficient was used to estimate the reliability of each scale. The Mann-Whitney U and Kruskal-Wallis tests were used to determine differences among demographic factors and outcome variable, and Pearson correlation coefficients were computed to establish whether there was any relationship between the three perception scores and the outcome variable. Multiple regression analysis was applied to identify factors associated with hand hygiene adherence. We used the statistical package for the social sciences (SPSS) ver. 13 (SPSS, Chicago, IL) to conduct all analyses. All statistical tests were two-tailed, and p-values < 0.05 were considered to be statistically significant. Results A total of 1,022 questionnaires were returned for an overall response rate of 59.3% (1,022/1,724). We excluded 14 questionnaires because of missing data. Thus, the study was based on a total of 1,008 questionnaires from 906 (89.9%) nurses and 102 (10.1%) physicians. Overall, the questionnaire had good internal consistency with Cronbach's alpha (0.95), whereas the alpha coefficient range for all multi-item scales was 0.84-0.91. Nurses and physicians have similar demographics, except for gender with 86% of nurses being female and 75% of physicians being male. On the whole, 21% of the nurses and 27% of the physicians were > 40 years of age, with 39% of the nurses and 48% of the physicians from the department of medicine. A total of 40% of each professional group has > 10 years of professional experience, while 36% of each group has worked in the institution for more 10 years. In terms of hand hygiene promotional experience and formal hand hygiene education training, 59% of the nurses and 73% of the physicians had participated in the former while 76% of the nurses and 68% of the physicians had received the latter. Perceptions toward HCAIs and Hand Hygiene Nurses and physicians vary slightly in their perceptions of the importance and impact of HCAIs as well as in their perceived effectiveness of hand hygiene, social expectations, and hospital average hand hygiene compliances. Overall, 70% of the nurses and 49% of the physicians perceived the percentage of patients with HCAIs to be greater than 15%. Comparatively speaking, a large percentage of nurses (83%) and physicians (62%) estimated that HCAIs would result in at least 5-day hospital stays. With respect to mortality rate, 79% of the nurses and 68% of the physicians believed that more than 5% of patients with HCAI would die as a result of the infection. In terms of infection prevented by hand hygiene practice, 60% of the nurses and 46% of the physicians acknowledged that over 75% of HCAIs could be prevented. A total of 40% of the nurses and 60% of the physicians perceived that the frequency of hand hygiene actions during patient care would be less than five times per hour, whereas 40% of the nurses and 23% of the physicians claimed that it would be six to ten times per hour. Despite this discrepancy of the perceived times per hour to cleanse their hands, 60% of the nurses and 30% of the physicians perceived that the average hand hygiene compliance at their hospital was greater than 75%. 10-20% more nurses than physicians perceived a safety climate with hand hygiene ranking as a top safety priority among the managers and themselves. Perceptions related to hand hygiene according to types of contact and clinical situations were computed by summing the item responses and dividing by the number of items answered by each participant to achieve scores for each of the variables. Overall, the mean score (± standard deviation, SD) for self-reported hand cleansing practice was 75.36 ± 1.63% (range 12.5-100%). Both nurses and physicians reported a high rate of hand cleansing practice after exposure to patient’s body fluids and a low rate before direct patient contact. Additionally, response scores in both groups regarding self-reported hand cleansing performance in different contact and clinical situations showed concordance with the three perception variables (perception in effectiveness of Health Science Science Nursing RESEARCH HNN108 Share QuestionEmailCopy link Comments (0)
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