Nudging to improve hand hygiene Assignment Help

Analysis of Medical Papers

1. What were the aims and/or objectives of the study?

The fundamental aim of this particular research study is to investigate the influence of behavioral nudges, in the form of posters, on the practice of hand rubs which are alcohol based. This aim of the research study is highlighted explicitly not only in the abstract but also in the later sections of the study.

2. What study design was used?

This particular research study used a mixed methods approach in order to meet the research aim. A mixed methods approach, according to Reed (2009), blends the quantitative and qualitative research designs. This particular approach calls for the adoption of both the deductive and inductive approaches to research and the study is characterized by the research philosophy of pragmatism which blends the philosophies of interpretivism (qualitative research design) and positivism (quantitative research design.) For the qualitative aspects of the research study, the research method of content analysis has been used whereas for the quantitative aspect of the study, survey analysis was used. The survey questionnaire that was designed for this study was actually a cross-sectional survey combined with controlled before-after trials. The convenience sampling strategy was used in order to collect primary quantitative data, using a survey questionnaire, from 110 students of medicine, 60 nurses from the chemical words and 27 doctors of internal medicine. The survey questionnaire was circulated amongst the research participants using survey monkey within the region of California in the United States. The respondents were also provided with as many as 10 different images and 8 slogans, and were asked open-ended questions as well regarding the same in the survey questionnaire. 

3. List the study factor(s) (i.e. Independent variable)

The independent variable for this study was the behavioral nudges directed towards the research participants. This independent variable was conceptualized using behavioral posters which urged the research participants to use alcohol-based hand rubs for hygiene purposes.

4. List the outcome(s) (i.e. Dependent variable)

The dependent variable for the research study is the behavior of the research participants. This dependent variable was conceptualized by counting the number of alcohol-based hand rubs.

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5. What study design would have given the highest possible evidence for the aim of the study?

The mixed methods approach has been used in this research study. However, there are certain limitations of this research design. One of the most important and critical limitations of this design is that it is very difficult for the researcher to justify the utilization of both the quantitative and qualitative designs at the same time. Specifically, the content analysis and the survey analysis – two of the research methods that have been used in this study – are not particularly recognized in the contemporary literature as being the research methods to gain the highest level of evidence.

In this connection, it would have been very beneficial for this research to use a qualitative research design combined with primary data collection in the form of interviews. The research method in this case that would have given the highest level of evidence is the thematic analysis of interviews.

6. What study design would have given the highest quality of evidence and would also have been feasible and ethical?

The primary qualitative research design and the use of thematic analysis of user interviews would have given the highest quality of evidence for the research area of focus. The feasibility of the methodology and the ethical considerations involved in this research design are also unchallenged as per the contemporary research (Mays & Pope, 1995; Frankel, 2000).

7. How were the results presented in the study?

The results of the recent study were presented in quantitative form such as in percentages. Graphical presentations of the results also follow the textual presentation. 

8. What were the major findings? What was their significance?

The study presents the idea that behavioral nudges which are based on biases of cognition can potentially increase the practice of alcohol-based hand rub when the nudges are displayed only next to dispensers. One of the six nudges displayed to the research participants had an impact on both the wards in context, while the other nudges enhanced the overall utilization of the dispenser on the entrance on one ward only. No change was observed in the usage of the dispensers where there was a lack of posters. The significance of the findings is that if medical practitioners and staff are continuously nudged for their hand hygiene, there is an improvement in the hand hygiene condition as visualized by the increase in the use of dispensers 

9. What statistical methods were used in the study? How was the data presented?

Poisson regression analysis was used in this study. This statistical method was adjusted for the workload.

10. What were the conclusions presented in the study? How did the authors justify this?

Nudges which are based on cognitive biases play an instrumental role towards hand hygiene. This is a very easy and an inexpensive major to enhance the usage of hand rubs based on alcohol. However, the identification of an appropriate nudge for the right target audience is important.

11. What were the strengths and weaknesses of the study?

The fundamental strength of the study is its simple and least complex presentation of the findings. However, there is an underlying weakness, namely that the study uses secondary qualitative data for content analysis, which is not an appropriate choice. As discussed earlier, the highest quality of evidence would have been obtained from a primary qualitative research design using the thematic analysis of user interviews.

HAND HYGIENE “HALL MONITORS”: LEVERAGING THE HAWTHORNE EFFECT

1. What were the aims and/or objectives of the study? 

The impact of hand hygiene all ministers was investigated in this research and this forms the fundamental aim of the research study. The first objective of this research was to investigate the role of the Hawthorne effect in the entire scenario. The underlying objective of the study was to propose an inexpensive and effective intervention which would only naturally improve the hand hygiene performance of a particular unit.

2. What study design was used? 

This study was an experimental research; the research hired a pragmatic teenager for a summer internship. The teenager was trained on a hand-held device – the hall monitor – and using the software application installed on the device, she collected primary quantitative data on the number of washes and the number of rubs in the hand hygiene unit. The study carried out 234 observations across the baseline period.

3. List the study factor(s) (i.e. Independent variable) 

The presence of a hall monitor setup may be considered as the dependent variable for this research.

 

 

4. List the outcome(s) (i.e. Dependent variable) 

The dependent variable of the study was the rate of hand hygiene compliance. This variable was conceptualized using the number of hand washes and the number of hand rubs observed through the hall monitor.

5. What study design would have given the highest possible evidence for the aim of the study? 

It must be noted that this particular study is characterized by a primary quantitative research design where the data collected is of a primary nature. However, it must be noted that one of the objectives of this study was to explore the role of the Hawthorne effect in the entire scenario. As a matter of fact, although the study attempts to justify the research objective, it has been observed that the role of the Hawthorne effect has not be in investigated in detail in this study. In this connection, the research design that would have given the highest possible evidence for the aim of the study is the secondary qualitative research design blended with the existing primary quantitative design. Had a mixed methods approach such as this – the one which blends qualitative content analysis with an experimental approach and statistical data collection – been adopted, the study would have been enriched in terms of the quality of evidence.

6. What study design would have given the highest quality of evidence and would also have been feasible and ethical?

The recommended research design of blending the qualitative content analysis with the existing quantitative experimental approach towards the research would have given the highest quality of evidence. At the same time, this mixed methods approach would have also been ethical and feasible.

7. How were the results presented in the study? 

The results of the study were presented in a textual form only. No graphical presentations were incorporated in the findings to explain the same in a better way.

8. What were the major findings? What was their significance? 

The major finding of the study was that the presence of a hall monitor only naturally increases the hand hygiene condition of the unit. The significance of this finding is for hospitals and related units that must have hall monitors installed. Another important finding of the study is that of the approach taken by the researchers towards the study; an intern was hired for collecting data through hall monitors. This particular approach proved to be very cost effective and inexpensive. Hence, the significance is twofold. Firstly, the intervention proposed in this study may be adopted by the hospital units. Secondly, use of hall monitors may be widely acknowledged in medicinal practice specifically pertaining to the issue of hand hygiene.

9. What statistical methods were used in the study? How was the data presented?

Simple statistical methods such as the probability tests were used in the study. The data was presented in a tabular fashion.

10. What were the conclusions presented in the study? How did the authors justify this? 

The conclusion was that during the baseline period, the rate of compliance was as much as 42.7 percent. However, during the period of intervention, this rate jumped to 80.9 percent. The conclusion of the study was that there is an important moderating role of the Hawthorne effect in the relationship between hand hygiene and the existence of hall monitors. However, despite this, it is evident that the authors have not been able to justify this role of the Hawthorne effect; the authors have not referred to the contemporary research to teacher and no historical any groups or pieces of empirical research literature have been cited for this sort of a justification.

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