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Clinical Issue

Another common aim healthcare workers cite for low hand hygiene adherence is lack of time. “The problem is definitely not absence of posters reminding staff to clean their hands on daily basis. It’s time for hospitals to stretch up on that as a mean of raising hand hygiene. Staff know they should exercise on proper hand hygiene.

Hand hygiene is a excessive way to avoid infections. Even healthcare workers are at risk of getting an infection while they are on duty of treating the patients. Preventing the spread of microorganisms is especially essential in hospitals and other services such as nursing homes and dialysis centers.

Hand Hygiene

PICO (T) Question

PICO (T) elements include:

P (Patient or Problem or population)

I (Intervention)

C (Comparison)

O (Outcome)

In our case the practice question can be: Does hand washing among healthcare staffs reduce hospital acquired infections

PICO – Evidence Based Medicine

Research Database

Here are some of the database used in the evidence-based practice:

  • CAUTI (Catheter Associated Urinary Tract Infection)
  • CLABSI (Central Line-Associated Bloodstream Infection)
  • CINAHL (Cumulative Index to Nursing and Allied Health Literature
  • MEDLINE (Medical Literature Analysis and Retrieval System Online)


Level of Evidence-Based Practice

The EPIC review providing evidence from challenges of several designs in a broad range of setting in specific enteric illness and intensive care that is handwashing helps to reduce infection rates.

Types of evidence-based practice used;

  • Level I – Systematic reviews of RCT
  • Level II – RCT
  • Level III – Systematic reviews of nonrandomized or cohort studies
  • Level IV – Cohort studies

Infection Control


Hand hygiene is termed by many health care staffs as a single most crucial tool in preventing the spread of heath-care related infection among patients.

According to WHO, there a chance of few definitive information on the patients-care processes that are most transmit bacteria to the workers in the health organization. Although bacteria have been discovered on HCW (health care workers) hands after events such as intravascular, catheter, respiratory tract care, and wound care.


Boyce, , Chartier, Y., Chraiti, M., Cookson, B., Damani, N., & Dharan, S. (2009). WHO guidelines on hand hygiene in health care. Geneva: World Health Organization.

Grol, , & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients’ care. The lancet, 362(9391), 1225-1230.

Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D., & Walker, (2005). Making psychological theory useful for implementing evidence based practice: a consensus approach. BMJ Quality & Safety, 14(1), 26-33.

Pittet, , Hugonnet, S., Harbarth, S., Mourouga, P., Sauvan, V., Touveneau, S., & Perneger,

  1. V. (2000). Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. The Lancet, 356(9238), 1307-1312.


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FALL PREVENTION is the chosen clinical issue of interest. 

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

· Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

· Identify and briefly describe your chosen clinical issue of interest. (Fall Prevention).

· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

· Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.

· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples. Include speaker note

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