Role Of Hand Hygiene In Clostridium Difficile Control

Role of Hand Hygiene in Clostridium Difficile Control

In the previously submitted work, the clinical importance of Clostridium difficile (C. diff) infections was evidently identified by referencing statistical data and reputable sources on the topic (Boyce & Zingg, 2017). The prevalence of the disease in clinical environments and the need for the elimination of negative consequences of C. diff spreading determine the primary scope of this evidence-based practice (EBP) proposal, which is to develop evidence-based guidelines for the prevention of the disease. This section of the EBP proposal focuses on the identification of a theoretical framework as well as a literature review of current sources on the research topic.

Theoretical Framework for the EBP proposal

Identification of the Theoretical Framework

As it is mentioned by Fuller ainsi que al. (2014), the particular implementation of theory-based approaches can considerably facilitate the effectiveness of hand cleanliness interventions in medical settings. For the particular purposes of it, the article simply by White et ing. (2015) was selected since the primary resource of advice about the assumptive framework that could advantage the EBP suggestion. White et ing. (2015) identify the particular planned behavior (TPB) theory, “a well-validated decision-making model which has been applied to hands hygiene in medical center along with other contexts, ” since the basis with regard to the improvement associated with hand hygiene amongst health workers (p. 60). Consequently , the particular usefulness and usefulness of this concept are proved used.

Description from the Theoretical Framework

The core assumption from the theory under conversation is the using: the individual’s conduct is largely determined by his or her intention, which is influenced by three primary factors: “attitude, subjective norm, and perceived behavioral control” (White et al., 2015, p. 60). Attitude refers to personal evaluations of certain behavior as positive or negative, very subjective norm defines the particular perceived social stress, and perceived behavior control refers in order to the ease or even difficulty to perform the particular behavior of attention (White et ing., 2015). These 3 domains represent the particular most critical places of concern when it comes to their impact upon the behavioral designs of an person. Another highly essential idea of the TPB theory is the particular belief base, which usually largely determines the particular individual’s behavior within three identified domain names.

The significance of the perception base is mainly based on the huge impact of individual’s assumptions about on their own as well as the people close to them. The main range of the TPB approach is in order to identify the person’s beliefs and after that to facilitate their or her conduct by exposing the particular individual to fresh beliefs or altering the existing ones. Since the problem under discussion is evidently connected with healthcare workers’ behavioral patterns, the identified theoretical Framework is highly useful for employment in the EBP proposal.

Literature Review on the Research Topic

First of all, it is essential to overview the articles which were used in the previous section of the EBP proposal. The report by Dubberke et al. (2014) represents a well-elaborated and comprehensive set of guidelines, which aims to highlight practical recommendations for the prevention of C. diff in acute care hospitals. The post is divided in to several sections, within which general plus C. diff-specific hands hygiene recommendations are usually provided. The efforts from reputable health care professionals, representing numerous organizations, largely determine the quality associated with the report (Dubberke et al., 2014). The second post that was utilized in the intro section of the particular EBP proposal will be written by Barker et al. (2017). Here is info of higher importance because it investigates the correlation among the number associated with C. diff spores on patients’ fingers as well as the use of various hand hygiene methods that are available in clinical environments. It is argued in the study that the possibility of C. diff contamination from patients’ hands is highly probable. The authors also compare the effects of alcohol-based sanitizers with soap and water, and they conclude that soap and water are more efficient; however , it is essential to use both methods to minimize the possibility of new contamination.

The following two articles that were chosen in the process of literature research could be discussed jointly, as they are both focused on the impact of sink location on hand hygiene compliance. The first article, written by Zellmer, Blakney, Van Hoof, and Safdar (2015), represents a quantitative study in which the method of direct observations was used. In the second article by Deyneko et al. (2016), a quantitative cross-sectional study, which is also based on the observation of healthcare workers and patients, is conducted. It is possible to state that the sample size differs significantly: the total number of 69 observations was made by Zellmer et al. (2015), which Deyneko et al. (2016) made 247 observations.

Both articles conclude that poor access to sinks decreases handwashing compliance significantly (Deyneko et al., 2016; Zellmer et al., 2015). However, Deyneko et al. (2016) do not provide concise guidelines for the improvement of the situation, while Zellmer et al. (2015) propose an evidence-based intervention of placing two more easily visible sinks in hospital environments. The importance of the studies under discussion is that the authors provide C. diff-specific observations, relatable for the majority of clinical environments. The data that could be retrieved from the articles is extremely significant for the development of evidence-based practice guidelines, which is the primary scope of this EBP proposal.

The next article under discussion, written by Landelle et al. (2016), is a prospective study, which strives to determine the risk factors associated with contamination of healthcare workers (HCW) hands with C. diff spores. The authors employ a considerably large sample of a participant in their research. It is proven in the article that nearly one-quarter of HCWs, who care for patients infected with Clostridium difficile, have their hands contaminated with C. diff spores. These results prove the urgent necessity for the development of a C. diff contamination prevention strategy. It is also suggested by Landelle et al. (2016) that the problem under discussion has a vastly negative impact on the entire high quality of caregiving within clinical environments.

A controlled quasi-experimental study by Longtin et al. (2016) is focused on a similar clinical problem as in the article mentioned in the previous paragraph, as the authors strive to understand how C. diff spores could be detected and isolated in clinical environments in order to decrease the level of healthcare-associated C. diff incidence. It is concluded by the authors the timely detection and isolation of C. diff carriers (who are primarily patients infected with the disease) significantly decreases the probability of new contaminations of C. diff by other patients and healthcare workers. The article by Longtin et al. (2016) represents current and actual information on the topic, and the results of the study are based on the information retrieved from a considerably large sample of participants.


Barker, A., Zellmer, C., Tischendorf, J., Duster, M., Valentine, S., Wright, M., & Safdar, N. (2017). On the fingers of patients along with Clostridium difficile: Research of spore frequency and the impact of hand cleanliness on C compliquer removal. American Diary of Contamination, 45(10), 1154-1156. Web.

Boyce, J., & Zingg, W. (2017). Role of hands hygiene in Clostridium difficile control. Within D. Pittet, M. M. Boyce, & B. Allegranzi (Eds. ), Hand Cleanliness (pp. 373-377). Brand new York, NY: Steve Wiley & Kids.

Deyneko, The., Cordeiro, F., Bremen, L., Ben-David, Deb., Perna, S., & Longtin, Y. (2016). Impact of kitchen sink location on hands hygiene compliance aftercare of patients along with Clostridium difficile contamination: a cross-sectional research. BMC Infectious Illnesses, 16(1), 203-210.

Dubberke, E. L., Carling, P., Carrico, R., Donskey, Chemical. J., Loo, Sixth is v. G., McDonald, L. C., … Gerding, D. N. (2014). Strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S48-S65. Web.

Fuller, C., Besser, S., Savage, J., McAteer, J., Stone, S., & Michie, S. (2014). Application of a theoretical framework for behavior change to hospital workers’ real-time explanations for non-compliance with hand hygiene guidelines. American journal of infection control, 42(2), 106-110.

Landelle, C., Verachten, M., Legrand, P., Girou, E., Barbut, F., & Buisson, C. B. (2014). Contamination of healthcare workers’ hands with Clostridium difficile spores after caring for patients with C. difficile infection. Infection Control & Hospital Epidemiology, 35(1), 10-15.

Longtin, Y., Paquet-Bolduc, B., Gilca, R., Garenc, C., Fortin, E., Longtin, J., … Ben-David, D. (2016). Effect of detecting and isolating Clostridium difficile carriers at medical center admission on the particular incidence of Chemical difficile infections: the quasi-experimental controlled research. JAMA Internal Medication, 176(6), 796-804.

White, K. Meters., Jimmieson, N. L., Obst, P. L., Graves, N., Barnett, A., Cockshaw, W., … Martin, E. (2015). Using a theory of planned behavior framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses. BMC Health Services Research, 15(1), 59-68.

Zellmer, C., Blakney, R., Van Hoof, S., & Safdar, N. (2015). Impact associated with sink location upon hand hygiene conformity for Clostridium compliquer infection. American Diary of Contamination, 43(4), 387-389.

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