Part 3. Review of the Literature

In this post you will provide a comprehensive Review of the Literature that you have found in your research about your PICOT question topic. Please see your textbook for the proper way to write a comprehensive review of the literature (ROL). You must review at least (at minimum) FIVE recent (< 5 years old) NURSING scholarly research articles related to your topic. You may add/discuss additional websites, textbooks or older articles but you must discuss and reference at least FIVE articles as described above.

You are required to attach your FIVE SCHOLARLY NURSING JOURNAL ARTICLES to your initial post.

Example – please note this is an older previous students work and so some references are older than 5 years.

Be sure to provide the PICOT question to begin this post.

PICOT Question:

P=Patient Population




T=Time (duration):

In patients in the hospital, (P)

how does frequently provided patient hand washing (I)

compared with patient initiated hand washing (C)

affect hospital acquired infection (O)

within the hospital stay (T)

Review of the Literature:

Although there is a substantial amount of literature on the effect of hand washing in health care workers, there is not as much pertaining to patient hand hygiene and hospital acquired infection (HAI). Strigley, Furness, Gardam (2014), provide a study to measure the instances of hand washing. There were faults to the measurement but it did provide a system to specifically document the act of hand washing. The results reveal that there is a level of decrease of microorganisms on hands, which then leads to a decrease of transmission of infections (Strigley, Furness, Gardam, 2014). Aziz (2014) reveals that hand washing ranked as the number one most important infection prevention and control measure. The organizational staff is a key to this study (Aziz, 2014). Hand hygiene protocols are important to initiate to start the cycle of prevention (Gujral, 2015). In the study by Fox, Wavra, Drake, Mulligan, Bennet, Nelson, Kirkwood, Jones, and Badger (2015) results indicate a hand washing decreased catheter associated urinary tract infection although it was not a significant change. A limitation is that the study was limited to the critical care unit. In contrast, DiDiodato’s (2013) broader study of 12 million residents in Ontario showed a significant reduction in incidences of HAI related to hand washing. Further research is needed to study specifically the effect of the patient’s role in hand washing and HAI. Nursing research allows us to comprise new strategies to help bring awareness of hand hygiene to patients.


Aziz, A. (2014). Hand hygiene compliance for patient safety. British Journal of Healthcare Management, 20 (9), 428-434. Retrieved from

Fox, C., Wavra, T., Drake, D., Mulligan, D., Bennet Y., Nelson, C., Kirkwood, P., Jones, L., Bader, M. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses hand washing. American Journal of Critical Care, 24(3), 216-224. DOI:

Gujral, H. (2015.) Survey shows importance of hand washing for infection prevention. American Nurse Today, 10 (10), 20. Retrieved from hEp://

Strigley, J., Furness, C., Gardam, M. (2014). Measurement of patient hand hygiene in multiorgan transplant units using a novel technology: An observation study. Infection Control & Hospital Epidemiology, 35 (11), 1336-1341. DOI:

DiDiodato, G. (2013). Has improved hand hygiene compliance reduced the risk of hospital-acquired infections among hospitalized patients in Ontario? Analysis of publicly reported patient safety days from 2008 to 2011. Infection Control & Hospital Epidemiology, 34 (6), 605-610.