RESEARCH CRITIQUES AND PICOT STATEMENT 2and other health care facilities. Per the Centers for Disease Control and Prevention, about half a million people were infected with C-diff in 2011. [Heand] Understanding the burden associated with Clostridium Difficile infection (CDI) patients and how it affects a nurse’s workload is imperative when assessing hand washing frequency. Supply and sink location must also be considered when assessing contact precaution and hand washing compliance. Evidence-based practice has demonstrated that the best way to limit transmission of C-diff is hand-washing with water and soap. [Dou14]The spores are resistant to alcohol-base hand foams. Hand-washing remains the most effective way to prevent C-diff transmission. (Frequently Asked, 2012) Removing barriers increases compliance and therefore improving patient outcomes.Qualitative Research CritiqueBackground of Study“Approximately 29,000 patients died within 30 days of the initial diagnosis of C. difficile. Of those, about 15,000 deaths were estimated to be directly attributable to C. difficileinfections, making C. difficilea very important cause of infectious disease death in the United States” (Centers for Disease Control and Prevention, 2015).If a person suspects they may have a CDI they should look for the following symptoms of watery diarrhea, abdominal cramping, and fever. These symptoms persist several days and may follow antibiotic use and/or a hospital stay. Certain people are at a higher risk for contracting a CDI infection including women over 65, antibiotic use within the past 30 days, the immunosuppressed, persons taking acid reducing medications, or a recent hospital or nursing home admission. If a CDI infection is confirmed, antibiotics should be started immediately to prevent compilations like dehydration, colitis, or sepsis (Agency for Healthcare, 2011).