Evidence-based practice (EBP) is an important clinical approach, which is aimed at improving healthcare outcomes (Barker, n.d.). It is based on two critical principles. First, all practical decisions in the healthcare sector should be supported by research studies (Houde, 2009). Second, studies should be designed and conducted using some basic rules contained in EBP (Houde, 2009). About clinical practice, good evidence is made up of findings from research studies that concentrate on detailed collection and analysis of data.
Data could be gathered through observations and experiments (Polit & Beck, 2012. It is essential to note that the development of questions and evaluation of hypotheses is critical in EBP (Davies, 2011). Hand washing and hand sanitizing are adopted to prevent infections in healthcare facilities (Pensacola Care Incorporated Policy and Procedure Manual, 2013). This paper aims at identifying a research problem and generating five questions that relate to the issue. In addition, it offers a preliminary PICO question.
A summary of my area of interest
My healthcare facility recommends that personnel should use hand sanitizers when it is not possible or practical to wash hands when handling patients. I would want to know whether a hand sanitizer would be effective for preventing infections compared with handwashing that is exemplified by the use of running water and soap. The director of nursing at my institution told me that the policy was adopted based on the current Center for Disease Control and Prevention (CDC) recommendations. I researched the issue, but I could not gather evidence to support that the policy was adopted on the platform of EBP and/or standards.
Although policies and procedures used in my organization are reviewed on an annual basis, there is little time to conduct EVP studies that would support them. It is essential to note that no designated person or department is charged with the responsibility of such studies. In addition, a lack of financial resources would hamper studies (Walden Student Center for Success, 2012).
Five questions and a description of analysis for feasibility
I have generated the following five questions:
- Is handwashing with soap and running water more effective for preventing infections in hospitalized patients than hand sanitizing with alcohol-based hand sanitizer?
- What is the role of handwashing in the prevention of infections?
- What is the role of hand sanitizing using hand sanitizers in the prevention of infections?
- What is the evidence of EBP concerning handwashing and hand sanitizing in the prevention of infections?
- What is the history of infections control related to handwashing?
The above questions were formulated because they proved to be feasible. The first question was adopted because it contained two variables for comparisons, i.e. hand washing and hand sanitizing. The second question was found feasible because it could look into the issue of preventing infections through hand washing. About the third question, feasibility was demonstrated by looking at the prevention of infections with the use of hand sanitizing. The fourth question was found practical because it could focus on analyzing evidence about preventing diseases using hand washing or hand sanitizing. Lastly, the fifth question was found appropriate because it could give evidence on the history of control of infections using hand washing.
Preliminary PICOT question and variables
The preliminary PICOT question is the following: Is handwashing with soap and running water more effective for preventing infections in hospitalized patients than hand sanitizing with alcohol-based hand sanitizer? It is important to underscore that the question was adopted on the basis that it contained most of the PICOT variables that are required for EBP (Davies, 2011). The first variable that would be analyzed is about patient population.
In this context, hospitalized patients would be studied. The second variable is related to the intervention. The proposed study would aim at offering patients the best approach to kill pathogens that cause infections due to contaminated hands. Comparison is the third variable that would focus on selecting either hand washing or hand sanitizing. The fourth attribute is the outcome, which would concentrate on achieving improved healthcare outcomes among hospitalized patients. Although the fifth element (time) of the PICOT format is not included in the PICOT question, a certain time frame would be utilized.
The following 10 keywords would be used when conducting a literature search for the PICOT question:
- Hand sanitizing
- Running water
- Hand sanitizers
- Hospitalized patients
- Hospital-based infections
- Prevention of infections
- More effective
The 10 keywords would be essential in obtaining information related to the question. The internet is characterized by databases that have a lot of information. It would be difficult to obtain information without using specific words about an issue (Krainovich-Miller, Haber, Yost & Jacobs, 2009; Robeson, Dobbins, DeCorby & Tirilis, 2010). Thus, the selections in the above list would help to narrow the extent to which required information would be searched.
Barker, J. (n.d.) Basic search tips and advanced Boolean explained. Web.
Davies, K. S. (2011). Formulating the evidence-based practice question: a review of the frameworks. Evidence-Based Library and Information Practice, 6(2), 75-80.
Houde, S. C. (2009). The systematic review of literature: A tool for evidence-based policy. Journal of Gerontological Nursing, 35(9), 9–12.
Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. K. (2009). Evidence-based practice challenge: Teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.
Pensacola Care Incorporated Policy and Procedure Manual. (2013). Hand-washing policy. Pensacola, FL: Pensacola Care Incorporated.
Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA: Lippincott Williams & Wilkins.
Robeson, P., Dobbins, M., DeCorby, K., & Tirilis, D. (2010). Facilitating access to pre-processed research evidence in public health. BMC public health, 10(1), 95-98.
Walden Student Center for Success. (2012). Clinical question anatomy. Web.