“Hand hygiene education and individual feedback of hand hygiene frequency and method were proven to decrease MRSA acquisition rate and MRSA colonization pressure.”
Do hand hygiene education and individual feedback on hand hygiene reduce MRSA acquisition and MRSA colonization pressure among intensive care unit nurses?
After the group education, hand hygiene means result increased from 2.84 to 3.65 and 3.89 (p = 0.001)
After the first and second post-education, the hand hygiene agent increased from 0.99 t0 1.00 (p = 0.013 and 0.053
The hand hygiene time increased from 0.26 to 0.63 (p = 0.001)
The total score of the hand hygiene method increased from 2.84 to 3.65 after hand hygiene education (p = 0.001)
The rate of MRSA acquisition reduced from 11.1%(5 patients) to 2.7%(1 patient) (p = 0.215 and further reduced to 0% after the next round of observation
The frequency of hand hygiene after nurses came in contact with MRSA, Vancomycin-resistant enterococci and imipenem-resistant Acinetobacter baumannii patients increased from 53.1% to 74.1% and 71.7% (0.001)
Reasoning (Why the evidence supports the claim)
After the first and second observations, the MRSA acquisition rate reduced from 13.3 per 1000 patient days to 2.6 and 0 per 1000 patient days (p = 0.118 and p = 0.071). Furthermore, the MRSA colonization pressure reduced to 28.8% and 8.6% (p = 0.038 and 0.001) after the first and second observations from 39.5% before education. The result shows that the evidence supports the claim that hygiene effectively reduces MRSA acquisition rate and MRSA colonization pressure.
Appraisal using Cohn et al. (2009)
According to Cohn, Jia & Larson (2009), for nursing journals or articles to yield reasonable outcomes to evidence-based techniques, ideal analytical analysis and Interpretations are vital. The nine criteria for appraising an article per Cohn et al. will be used to support the claim by Chun et al. 2014
Power Analysis – this criterion was not met as the study contained no power analysis
Analytical Approach – the study was a quasi-experimental study, which was an appropriate analytical approach.
Addresses hypothesis or research question – this criterion was met because the analysis addressed the hypothesis
Normality assumption of data – the criterion was met as the study was analyzed using chi-square and fisher’s tests
Level of data – this criterion was not met as the article did not provide the complete data
Description of statistical and analytical approach – this criterion was met as the statistical test matched the level of data provided
Report of Descriptive and inferential statistics – this criterion was not met because there were no raw data reported
Sufficient description of the analytical approach – this criterion was met because the research provided enough detail for the analysis.
Differentiates between clinical and statistical significance – this criterion was met because it reflected how frequent and proper handwashing can help reduce MRSA and other healthcare-associated infections.
Although the study by Chun et al. (2009) did not meet all the criteria as specified by Cohn et al. 2009, I strongly conclude that the claim was statistically and clinically significant.