Statistical Tests

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Chi-square Test

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The chi-square test (x²) is most commonly used in testing when there is a single outcome and two or more groups are involved. Chi-square tests whether the distribution of the outcome (proportions) is different among the intervention group versus the control group. It is used to test hypotheses about differences in proportions (Polit & Beck, 2018).

An example of a chi-square test would be a controlled study to assess whether hand hygiene would be improved with education on proper handwashing technique. A chi-square test would be used to study the difference education had on hand hygiene and the number of germs left on the hands. One would compare the difference in germs on the hands using fluorescent containing gel, ultraviolet (UV) lamp, and a black box. Hand hygiene would be assessed before and after participating in different activities in both the control and experimental group. Chi-square would be implemented to see if the difference in hand hygiene in the two groups is clinically significant. If the theoretical value, let’s say is 3.85 and our obtained value is 4 then we can conclude that yes, in fact, the data is significant. In this example using chi-squared, both the independent and dependent variables would have a measurement level of nominal. Four levels of measurement exist nominal (classification into mutually exclusive categories), ordinal (ranking), interval (rank order and distance between), and ratio measurement (similar to the interval but having a rational zero point) (Polit & Beck, 2018, p. 257).

Chi-square is great for testing the difference in proportions in 2 or more independent groups and is often needed in many research study designs. Typical wording for chi-squared testing reads like, “patients in the experiment group had a significantly lower rate of infection than those in the control group” (Polit & Beck, 2018, p. 252).

Two articles I have listed are both related to hand hygiene and testing using chi-square. According to Ferhoudi et al. (2016) There was a significant change in compliance before and after implementation of WHO’s Multimodal Improvement Strategy (29.8% and 70.98%, respectively.). It was concluded that through this study using chi-square, implementing WHO hand hygiene program can significantly improve hand hygiene compliance among nurses.

Another study related to hand hygiene states that it was found that the post-program scores increased at a statistically significant level in all regions of both hands in comparison with the pre-program scores (p < .05). The values did not change within the control group (p > .05) (Öncü, et al., 2019). This shows the data is significant.

Farhoudi, F., Sanaei Dashti, A., Hoshangi Davani, M., Ghalebi, N., Sajadi, G., & Taghizadeh, R. (2016). Impact of WHO hand hygiene improvement program implementation: A quasi-experimental trial. BioMed Research International, 1–7. https://doi.org/10.1155/2016/7026169

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