RUA Group

Article

References

Purpose

Hypothesis

Study Question(s)

Study Variables

Study Design

Sample

Size &

Selection

Data Collection

Methods

Major Finding(s)

1

(SAMPLE ARTICLE)

Smith, L. (2013).

What should I eat? A focus for those living with diabetes. Journal of Nursing Education, 1 (4) 111-112.

How do educational support groups effect dietary modifications in patients with diabetes?

D-Dietary modifications

I-Education

Qualitative

N- 18

Convenience sample-selected from local support group in Pittsburgh, PA

Focus Groups

Support and education improved compliance with dietary modifications.

1-Abby

Yanke, E., Moriarty, H., Carayon, P., & Safdar, N. (2021). “The Invisible Staff”: A qualitative analysis of environmental service workers’ perceptions of the VA Clostridium difficile prevention bundle using a human factors engineering approach. Journal of Patient Safety, 17(8), e806–e814.

To explore environmental service workers’ perceptions of the barriers and facilitators that influence adherence to the Veterans Affairs C. difficile prevention bundle using the SEIPS human factors model.

Qualitative themes, not variables

Qualitative descriptive study using a focus group; SEIPS human factors engineering framework.

N=7

Convenience sample

Recruited from a single VA medical center

60-minute focus groups audio recorded.

-ESWs had strong knowledge of CDI hand hygiene requirements.

-Barriers included inadequate space, difficulty enforcing visitor PPE adherence, interruptions while cleaning, and discomfort correcting physicians.

-Facilitators included adequate supplies, supportive supervisors, clear cleaning protocols, and strong work ethic.

2-Abby

Banks, M., & Phillips, A. B. (2021). Evaluating the effect of automated hand hygiene technology on compliance and C. difficile rates in a long-term acute care hospital. American Journal of Infection Control, 49, 727–732

To evaluate whether implementing automated hand-hygiene monitoring technology increases staff compliance and reduces C. difficile infection rates in a long-term acute care hospital.

Independent Variable: Introduction of automated hand-hygiene technology

Dependent Variables: Hand Hygiene compliance, C. Diff infection incidence,

Non-randomized pre/post intervention study (12 months pre-implementation vs. 12 months post-implementation).

All clinical staff during study 3,778,830 monitor-captured Hand hygiene moments

Automated sensor system results

-Hand Hygiene compliance significantly increased from 89.82% to 97.10%

- C. difficile incidence significantly decreased from 9.54 to 3.72 per period

-Technology identified far more hand hygiene opportunities than traditional hand-audit observation.

-Alcohol-based sanitizer consumption more than doubled.

3 Lydia-Tilaciou

Comparcini, D., Simonetti, V., Segala, F. V., Di Gennaro, F., Bavaro, D. F., Pompeo, M. A., Saracino, A., & Cicolini, G. (2023). Nurses’ knowledge, attitudes and practices on the management of Clostridioides difficile infection: A cross-sectional study. Antibiotics, 12(3), 529. https://doi.org/10.3390/antibiotics12030529

To evaluate nurses’ knowledge, attitudes, and practices regarding Clostridioides Difficile Infection management and prevention.

Higher levels of Clostridioides Difficile Infection-related knowledge among nurses are associated with better infection-prevention practices.

What are nurses’ knowledge levels, attitudes, and clinical practices related to Clostridioides Difficile Infection prevention and management?

Independent Variable: Knowledge/attitudes. Dependent Variable: Infection-prevention clinical practices (including hand hygiene and contact precautions).

Quantitative cross-sectional design.

424 registered nurses recruited via convenience sampling from three hospitals in Italy.

Self-administered online questionnaire assessing knowledge, attitudes, and practices; analyzed using descriptive and inferential statistics.

Nurses demonstrated strong awareness of Clostridioides Difficile Infection risks but insufficient understanding of correct disinfection procedures and optimal hand hygiene timing. Higher knowledge scores were associated with significantly better infection-control practices (p < 0.05). Authors recommended targeted education programs to raise compliance and reduce Clostridioides Difficile Infection transmission.

4 Lydia-Tilacious

Lev, V., Anbarchian, T., Yao, H., Bhat, A., Britt, P., & Shieh, L. (2024). Health care–associated Clostridioides difficile infection: Learning the perspectives of health care workers to build successful strategies. American Journal of Infection Control, 52(3), 284–292. https://doi.org/10.1016/j.ajic.2023.08.008

To explore healthcare workers’ perspectives, barriers, and facilitators associated with preventing healthcare-associated C. difficile infections.

Healthcare worker insights can guide the development of more effective Clostridioides Difficile Infection Prevention strategies.

What barriers and facilitators do healthcare workers identify regarding Clostridioides Difficile Infection prevention efforts?

Qualitative study — variables not isolated/quantified; themes included communication, environmental cleaning, hand hygiene, and workflow factors.

Qualitative descriptive study using semi-structured interviews.

45 healthcare workers (nurses, physicians, EVS, infection preventionists) recruited through purposive sampling in a large academic medical center.

Audio-recorded interviews transcribed verbatim; thematic analysis conducted by two independent coders.

Inconsistent hand hygiene, staffing shortages, unclear Clostridioides, Difficile Infection protocols, and insufficient interdepartmental communication were major barriers. Participants noted that reinforcing hand hygiene practices, improving workflow, and providing targeted education can reduce Clostridioides Difficile Infection rates.

5-Nicole

6-Nicole

7-Olivia

8-olivia

9-aissata

Kaushik, A., Beal, K., & Gupta, S. (2023, December). 689. Significant Improvement in Hand Hygiene Compliance and Decline in Clostridioides difficile Infections with Implementation of Infection Prevention Interventions. In Open Forum Infectious Diseases (Vol. 10, No. Supplement_2, pp. ofad500-751). US: Oxford University Press. https://doi.org/10.1093/ofid/ofad500.751

The purpose of the study was to evaluate the impact of a multifaceted infection prevention and control (IPC) intervention program on hand hygiene compliance and Clostridioides difficile infection (CDI) rates in a tertiary care hospital. The hypothesis was that implementation of targeted IPC interventions would significantly improve hand hygiene adherence among healthcare personnel and reduce CDI incidence.

· Independent Variable: Multifaceted IPC interventions (auditing, education, real-time feedback, posters, huddles, contact precautions reminders).

· Dependent Variables: Hand hygiene compliance rates of healthcare personnel; incidence of hospital-acquired C. difficile infections (per 1000 patient days).

Quasi-experimental, pre-post intervention study comparing outcomes before and after implementation of IPC measures.

160-bed tertiary care center serving Iowa, South Dakota, and Nebraska. All healthcare personnel (physicians, nurses, nurse practitioners/physician assistants, and ancillary staff) were included in compliance monitoring.

· Auditing and real-time observation of hand hygiene compliance.

· Monitoring usage of hand hygiene products (soap and sanitizer).

· Educational interventions (posters, weekly nursing huddles, provider counseling, continued coaching).

· Pre-intervention period (P1: 1/10/2021-6/30/2022) compared with intervention period (P2: 7/01/2022-3/31/2023).

· Overall hand hygiene compliance increased from 71% (P1) to 85% (P2) (p < 0.05).

· Compliance improved across all personnel categories: physicians (74% - 92%), nurses (68% - 94%), nurse practitioners/physician assistants (75% - 90%), ancillary staff (60% - 89%).

· Soap usage increased from 45% to 75% (p < 0.05).

· CDI rates significantly declined from 1.9 infections per 1000 patient days (P1) to 0.5 infections per 1000 patient days (P2) (p < 0.001).

· Standardized Infection Ratio decreased from 1.14 to 0.4 (p < 0.01).

11-tracEy

12-tracEy

Carling PC, O'Hara LM, Harris AD, Olmsted R. Mitigating hospital-onset Clostridioides difficile: The impact of an optimized environmental hygiene program in eight hospitals. Infect Control Hosp Epidemiol. 2023 Mar;44(3):440-446. doi: 10.1017/ice.2022.84. Epub 2022 Jun 20. PMID: 35718355; PMCID: PMC10015263.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10015263/?utm_source=chatgpt.com

To explore the effects of an optimized environmental hygiene program on the spread of C. difficile across eight hospitals.

Independent Variables: Daily mass hospital cleaning, cleaning programs, monitoring and performance

Dependent Variables: Onset C.difficle rates in the hospital,

Quantitative

8 acute-care hospitals in 6 states. Hospitals ranged in size from a 532-bed tertiary-care hospital to a 44-bed regional critical-access hospital (mean, 257 beds)

Hospital records and labs. Cleaning audits and staff process monitoring of times (18 months)

C. difficile infections dropped by about 50%, and cleaning quality improved when all 8 hospitals implemented the new cleaning program