Guidelines For Improving Hand Hygiene Compliance

Hand hygiene practices are important thing to infection prevention and control practice. As health provider especially ED staff or front liner, to follow hand washing protocols is necessary in any situation. According Practice Standard (2009) four major elements to preventing practice; hand washing, protective barriers, care of equipment and health practice of nurse. Cite from Health Promotion Agency for Northern Ireland, scientists has found around 45% of infections can be prevented by washing hands regularly. MOH (2010) increasing in hand-washing compliance by

Another problem that goes with the lack of hand-hygiene compliance is the many excuses that healthcare workers use to avoid washing their hands. Hass and Larson summarize (2009) some of the barriers to adherence that healthcare workers use, “a lack of access to hand-washing sinks, insufficient time, skin irritations, and lack of accountability” (Hass & Larson, 2009). Some solutions they explain to combat the barriers are to put more alcohol-based sanitizers where sinks are not around and placing them all over the patient care areas also reduces time and can be a suitable way for proper hand hygiene if the healthcare worker’s hand is not soiled. They also describe, “Involve staff in trying several alcohol-based hand sanitizers before deciding on one, and involve employee health services in creating a plan to manage hand-skin problems among staff. Alcohol-based sanitizers that have lotion in them can be helpful for staff who have very sensitive skin” (Hass & Larson, 2009).

Keeping our hands clean is one of the most effcient and important steps we can do as humans to avoid getting sick or spreading germs to other people. Unwashed hands spread many diseases such as the flue, E. coli, and salmonella. Unfortunately, hand hygiene is still one of today’s most leading causes of infection in health care facilities. The risk of clinicians, patients, and visitors not complying with hand hygiene protocols creates a practice problem for nurses and their patient care. The cause of health care infections, also known as, health care-associated infections (HAIs) are increasing along with the rise of the inability to control or treat infections that are multi-drug resistant. Lack of proper hand hygiene is a major problem in clinical settings sourcing from critical care divisions where the most contaminations are prevalent. This paper will discuss how hand hygiene affects the nursing process and solutions of how to better prevent HAIs within the nursing scope of practice.

BackgroundInformation|This study examines the implementation of the Center for Disease Control and Prevention (CDC) hand hygiene guidelines and analyzes whether compliance impacts patient outcomes, especially hospital acquired infections (HAI). The correlation of hand hygiene (HH) and HAI is very well described in this study. Rates for HAI were determined both pre and post

CDCs clean hands count campaign aim to improve healthcare provide adherence to hand hygiene recommendations, address, myths and misperceptions about hand hygiene and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands and the most germs that cause serious infections in healthcare are spread by people’s action, every patient is at risk of getting an infection while they are being treated for something else, hand hygiene is a great way to prevent infections and healthcare providers clean their hands less than half of the time they should, good hand washing is the first line of defense against the spread of many illness.

Generations of people have considered handwashing a measure of personal hygiene. In 1847, Dr. Semmelweis insisted that healthcare providers wash their hands with disinfecting agents between patients. This early hand hygiene practice resulted in a decrease in mortality rates among hospital patients (CDC, 2002). The CDC’s Healthcare Infection Control Practices Advisory Committee published the Guideline for Hand Hygiene in Health-Care Settings in 2002 that is based on hand hygiene foundations developed in generation past. In 2014, this guideline is still available online and used as a reference

There are numerous evidence-based practice interventions that have become standard nursing practices across the country. Hand hygiene is a nursing practice intervention that is currently evidence (research) based. It is one of, if not the most, important interventions practiced in providing standardized care. The rationale behind that statement refers to the high percentage of hospital acquired infections; hand hygiene practices are measures used for maximum effectiveness in reducing the spread of these infections. Compared to the various health care professionals who come in contact with patients when providing care, nurses are by far the largest faction that implements the highest quantity of direct patient care in health care. That said, of all the asepsis precautions, techniques, and interventions that are currently in place, hand hygiene is the single most effective intervention used by nurse to prevent themselves from infection and the cross-infection to their patients. Although this evidence-based intervention is of utmost importance to implement at all times, research shows the difficulty in influencing nurses and other health care professionals to practice hand hygiene as often as recommended.

Patients have observed several physicians and nurses not washing their hands before interacting with patients. Hand hygiene is one of the largest tactics to combat nosocomial infections. The hospital should adopt a culture of 100% compliance with hand washing. The first step would be to increase handwashing stations and have more quick-dry alcohol-based antibacterial soap dispensers. Making access easier and decreasing the time taken to wash one’s hands would encourage adherence the policy. Furthermore, each floor should track hand washing and report data of potential nosocomial infections caused by improper handwashing. Keeping patients protected from bacteria is important especially when most are in an immunocompromised

Prevention strategies of nosocomial infections related to poor hand hygiene include revision of: orientation, training processes, competency assessments, equipment cleaning, handwashing procedures, switching to the use of single-use IV flush vials, adding strategically located waterless hand rubs, defining supervisory expectations, conducting in-services, team trainings, and tracking systems (Infection control related sentinel events, 2003). Potential solutions to noncompliance include: consistent skin protectant application, reduced time required for handwashing, and antiseptic stations at the bedside and room entry points (Boyce, 1999). Hospital administrators must create an organizational atmosphere in which adherence to recommended HH practices are considered an integral part of providing high-quality care (Boyce, 1999). Improvement in infection control

In other to be successful in improving adherence with hand hygiene policies and procedures at the hospital, the system of change strategy will be multimodal and comprise staff education and motivation, the use of performance indicators, and hospital management support (Troy, n.d.). Effective campaigns will bring about lessened contamination rates, antimicrobial resistance spread, and improve patient safety. The multidisciplinary strategy will include: (British Columbia Ministry of Health, 2012)

One the main roles healthcare workers (HCWs) can do is to provide patients with a safe environment whilst they are in the healthcare setting. In providing clinical safety to patients HCWs are ensuring that the patient will be safe from preventable adverse events occurring to them whilst they are in the hospital setting. Patient safety should be a of high priority to the healthcare setting and HCWs. Nursing staff are the main providers of care to patients whilst in the healthcare setting and have many responsibilities in delivering safe patient care. Whilst in the healthcare setting patients are vulnerable and at the hand of healthcare workers, thus it is extremely important for healthcare workers to maintain hand hygiene. To maintain a

Healthcare associated infections have an impact on patients - how? Can be prevented greatly with compliance to hand hygiene protocols (REF).

The need to wash hands has been proven to be beneficial in decreasing Hospital Acquired Infections (HAI) since the time of our foundress, Florence Nightingale was practicing. Though this is widely understood to be beneficial, healthcare providers have consistently scored poorly on studies regarding compliance to hand washing with a rate of 39% on average. In the United States, the healthcare industry has felt an economic burden due to HAI’s which account for the largest rate of morbidity and mortality. HAI prevention is possible with the practice of hand hygiene which is the single most important task healthcare providers can offer. Diegel-Vacek & Ryan, (2016).

Are the current infection control practices not enough to control this problem? Low infection control can be influenced by factors such as increasing inpatient acuity of illness, inadequate nurse-patient staffing ratios, unavailability of system resources. Even that healthcare personal is knows the importance of hand washing in infection control, evidence based studies have shown the not adherence to this simple practice. For this reason a constant re-evaluation of infection control guidelines, and application techniques must be a continuous practice in every healthcare center. Being healthcare workers (doctors, nurse practitioners, nurses, nurses aids, and healthcare worker in general) the front line defense against hospital acquired infection applying daily infection control practices to prevent cross contamination and spread of infections is the key. For this reason all healthcare staff must receive continuous education and training about infection control, correct hand hygiene technique, and use of alcohol base hand rubs. Infection control culture and clinical staff engagement are crucial to increase appropriated level of care, and decrease infections

Recent studies show that at any time, over 1.4 million people worldwide suffer from hospital-acquired infections (Public Health Ontario). In Canada alone, approximately 250 000 patients every year contract infectious micro-organisms from their healthcare providers (Nagel 18). At London Health Sciences Centre (LHSC) we take pride in providing world class care in a safe, comfortable environment for patients. However, between 2008 and 2010 the LHSC still had between 20 and 30 per cent non-compliance to proper hand-washing protocol (Nagel 20). This data is very troubling considering it is following the launch of “Just Clean Your Hands” pilot project. As student nurses and volunteers of the LHSC team we are equally responsible to increase hand-washing compliance.