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Critique of Systematic Research Review

Critiqueof Systematic Research Review

Critiqueof Systematic Research Review

Accordingto the article on hand hygiene adherence in patient care by Gould etal., (2010) infections that arise due to health services rendered topatients are major causes of death, thus physicians need to keeptheir hands clean as an effective preventive measure. Today, mostpatients risk being infected with diseases that they did not sufferfrom before gaining entrance to the health facility. A large numberof health-related infections are spread by coming into contact withunsterilized hands of health care employees. For a long time, keepingone’s hands clean before touching a patient has been regarded asthe best means of decreasing these infections, thus the use of soapand surgical spirit for hand washing among physicians. However, thelevel of compliance with this hand hygiene requirement is not up tothe required standards, thus the need of finding out whether thereexist methods that are more effective to enhance hand hygienecompliance.

Criticismof the Levels of Evidence for the Methodology Used

Theresearch design took into consideration a number of studies thatincluded controlled before and after studies (CBAs), controlledclinical trials (CCTs), and randomized controlled trials (RCTs) amongothers. Studies that reported proxy pointers of hand hygienecompliance, for instance, a rise in the use of alcohol-based or soaphand rub, were taken into consideration. According to the study, tobe qualified for assessment, ITS research had to show a preciselyelaborated instance when the involvement took place and had toincorporate at least three data sets. Moreover, all the researchdesign used had to have impartial measurements of the result ofinterest in addition to applicable and interpretable data presentedor accessible. One limitation with the CBA research method selectedby the authors is associated with confounding. In that, the CBA studyincorporates the comparison of two or more groups where one of thegroups is the experimental one while the other is the control group.Even though the selection of groups is not made in a random manner,the pre-test measurements help to inform individuals whether the twofactions are the same. Thus, if a shift between the post-test andpre-test measurements is seen only for the intervention faction, thehypothesis of casual interference is more pronounced than it would behad there been no control faction for the comparison.

Critiqueof the Precision with which the Research are Presented

Thepresentation of the research has been done an orderly manner as theauthors begin by elaborating the background of the study, which isthe high number of deaths caused by healthcare associated infections.In that, the driving factor of the study is the infections that arisefrom poor hand hygiene among health care providers, thus measuresneed to be put in place to ensure hands are thoroughly cleaned. Afterstating the background of the study, the researchers go on toelaborate the objectives of the research, which are assessing thereview conducted in 2007 and assessment of the intermediate andprolonged achievement of the strategies to enhance hand-washingadherence. Additionally, the authors have elaborated a clear searchstrategy that includes internet searched on medical databases likeMEDLINE, BNI, EMBASE, and the Cochrane Central Register of ControlledTrials. The selection of the control trials has also been elaboratedin a by the authors as they selected their sample randomly. However,the authors failed to indicate the limitation of the studyconsidering that the research design methods used had a number oflimitation that users of the result need to consider. The best partof the paper was on the implication since the authors clearlyoutlined the need of more researches to analyze how effective are theinterventions intended to enhance hind-hygiene compliance.

Descriptionof the Overall Results of the Research

Regardingthe results of the study, only four of the research designs attainedthe criteria for review with two of them obtained from the mainreview while the other two obtained from the update. Two of thestudies carried out an evaluation of simple education initiatives,one of them utilizing clinical trial methodology picked randomlywhile the other involving a CBA methodology. These two studiesanalyzed hand hygiene adherence through direct observation while theother two methodologies were interrupted times series. The results ofthe studies showed that there was an improvement in one of thestudies that incorporated measurements via observation, but theoutcome of the other research methodologies was not conclusive. Inthe other two studies, there was a rise in product use withinconsistent outcome obtained for one of the initiatives. Onelimitation seen in the result is the high number of inconclusive andinconsistent outcomes in the studies methods, which indicate that theresearch done by the authors may not be effective for adoption. Inthat, the authors failed to prove beyond reasonable doubt, throughthe analysis of their data, that attempts to enhance hand hygieneadherence are worth undertaking. Even though the results were not asexpected, the role of hand hygiene in the clinical setting cannot bedownplayed because of the number of lives one can save be ensuring heor she adheres to these requirements.

Critiqueof the Conclusions of the Research, With Repercussions for YourCurrent Practice and Future Research

Accordingto the authors of the article, the effectiveness of interventionmethods incorporated to enhance hand washing adherence remainsunsatisfactory. Even though complex promotions with publicadvertising or employees’ involvement are seen to have aninfluence, there is inadequate proof to base a strong conclusion.Therefore, there is still a critical need for carrying outmethodology intensive research to find out the efficiency of sanelydesigned and executed measures to enhance hand wash adherence. Theconclusion of the paper poses, as a setback in the hand hygienecampaign considering that it does not show the implementedinterventions are useful or worth investing on. Hand hygiene isimportant both in the present practice and in future practices, thusthe intervention implemented need to be seen as effective toencourage resource pumping on them. The only intervention that wasfound to be effective by the authors was employees input and socialintervention, thus health facilities need to invest on the twoindicators to ensure health hygiene is adhered to by clinicians.Moreover, there is a dire need for additional research in the sector,which should be done in a systematics manner to avoid inconsistentand inconclusive results.

Inconclusion, the systematic research review has been elaborated in asystematic manner since the authors have clearly indicated thesection of the paper from the background studies to the objectives tothe results among others. However, the SSR is not very effectivebecause of the large portion of inconsistent and inconclusiveresults, thus the need for additional studies. However, healthfacilities can begin with staff input and social intervention sincethe two interventions proved to be effective as compared to theothers.


Gould,D. J., Moralejo, D., Drey, N., &amp Chudleigh, J. H. (2010).Interventions to improve hand hygiene compliance in patient care.&nbspTheCochrane Library.