Careful and Constant and Hygiene Is Necessary to Reduce the Chance

question 21

Essay

Careful and constant and hygiene is necessary to reduce the chance of transmitting
pathogens by healthcare professionals. Despite the importance of hand hygiene,
getting good compliance is challenging. One complicating factor is the potential for
observer bias. That is, compliance monitors might be fellow workers who might
report higher compliance than neutral observers. A study designed to assess this
possibility was conducted in a hospital in a large city. Trained observers working
"under cover" - monitored hand hygiene compliance of a randomly selected sample
of healthcare professionals over a calendar year. Some observers worked in the same
hospital as the professional being observed (Unit-based) while others did not (Non-
Unit-based). Data from one of the hospital units are presented in the table below.
Do these data provide sufficient evidence of the existence of observer bias? $$\begin{array}{l}\text { Hand hygiene compliance: Unit- and Non-unit-based monitors }\\\begin{array} { | c | c | c | c | } \hline \text { Observers } & \begin{array} { c } \text { Unit } \\\text { based }\end{array} & \begin{array} { c } \text { Non } \\\text { Unit based }\end{array} & \text { Total } \\\hline \text { Compliance } & 92 & 188 & 280 \\\text { Non-compliance } & 37 & 108 & 145 \\\text { Total } & 129 & 296 & 425 \\\hline\end{array}\end{array}$$ a) What are the appropriate null and alternative hypotheses?
b) Show the necessary calculations to demonstrate it is reasonable to use the large-
sample test for a difference in population proportions for these data.
c) Test the hypothesis you indicated in part (a), and interpret your result in the
context of the study.

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Definitions:

Cognitive Development

The process of growth and change in intellectual capabilities, influencing how one perceives, thinks, and understands the world.

Jean Piaget

A Swiss psychologist known for his pioneering work in the study of child development and his theory of cognitive development.

Milestones

Significant points in development or events marking important stages or achievements in a process.

Dominant Gene

A gene that expresses its phenotype over another gene, the recessive gene, when they are both present in a pair of alleles.