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
Atul Gawande explains the single biggest problem facing hospitals in the spread of infection in his novel, Better. This is expressed in his conversation with the infection control team, where it is said that “their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infection: wash our hands. (Gawande, 2007, 14)” He notes that diligence, one of his three core requirements for success in medicine, plays a huge role in enforcing a policy like handwashing. While everyone knows hand washing is important, especially in a hospital, letting health care professionals ignore the practice and make their own decisions about its criticality harms the whole population.
The main of focus of the quality improvement program is always patient’s safety, needs, quality care and expectations. Even though the healthcare system is very critical as it involves the lives of other, there are some errors that can lead to undesirable consequences. One of the most common error that risks the lives of thousands of people including both patients and healthcare employees is the hand hygiene. Healthcare personnel are the leading source for the spread of Hospital acquired Infections. Every year about one million people die from hospital acquired infections in United States.
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.
(McCaughey, 2016). The Center of Disease Control recommends hand washing with vigorous scrubbing for at least 15 seconds with soap and water. Using alcohol based gel hand sanitizer can be an appropriate alternative if soap and water is not readily available but does possess drawbacks including being ineffective against alcohol resistant bacteria. Programs for surveillance have also been implemented in hospitals with the intention of monitoring staff to ensure that policies are being followed to ensure the safety of the patients. Mandated reporting of hospital-specific rates and statistics for healthcare-associated infections has the potential to serve a purpose that could result in bringing down the instance for infection. Being forced to announce to the public infections rates versus other healthcare organizations has the potential for higher administration to implement better policies to assure their good standing in the eye of the
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
First, reducing the risk of healthcare associated infections is implemented a few different ways. One of the ways is proper hand hygiene, by setting goals to improve the compliance of employees it will aid in lowering the percent of healthcare associated infections. This doesn’t just reduce the risk for infections but it mostly reduces the risk of antibiotic-resistant bacteria. (May 5: Hand Hygiene Day, 2014) About 2 million people in the United States obtain infections that are resistant to antibiotics and over 22,000 people die from these infections every year (May 5: Hand Hygiene Day, 2014). Hand hygiene isn’t just about washing your hands there are other aspects to hand hygiene that are just as important. The Joint Commission has issued specific guidelines that follow hand hygiene and require that organizations are to comply with these guidelines to remain accredited. (Joint Commission, n.d.) Many aspects of hand hygiene that are monitored such as when to wash, how long to wash for, which cleaning agents to use, when it is appropriate to use disposable gloves, and whether or not it is acceptable to wear artificial nails or jewelry. (May 5: Hand Hygiene Day, 2014)
Hospital-Acquired Infections entail, urinary tract infections, pneumonia and bloodstream infections. In addition to the patients, the Infections tend also to affect the healthcare workers who usually take care of the patients who are the main sources of the of the infectious diseases in the hospitals. The project tends to investigate the best evidence-based practices and approaches used to reduce the rate transmission and spread of the HAIs, such as washing of hands by healthcare workers. The statement of the problem focuses on the best methods and efforts that can be developed and implemented in the hospitals with the objective of preventing the Hospital Acquired Infections contributed by healthcare workers and the patients who come for treatments at the hospitals (CDC, 2016).
Hospital acquired infections are responsible for more than 90,000 death in the United States (Fox, 2015). Some of these infections include catheter-associated urinary tract infection, central-line associated bloodstream, and ventilator-associated pneumonia. These infections mostly affect those patients with an already compromised immune system (Fox, 2015). Therefore, it is the healthcare provider’s responsibility as well as the patients to prevent spreading of these infections by taking the necessary steps like performing hand hygiene. In a study performed by Fox (2015), nurses taking care of patients in the intensive care unit were asked to wipe the patient’s hands with a 2% chlorhexidine gluconate disinfectant wipe. This product provides
Healthcare associated infections have an impact on patients - how? Can be prevented greatly with compliance to hand hygiene protocols (REF).
Research shows that Surgical site infections are preventable. According to the CDC, hand hygiene is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Ensuring the use of infection control prevention is an important component of nursing care. Infection control prevention policies must be communicated undoubtedly to all employees. Staffers who do not comply must be re-educated to ensure that all are complying. Speaking up and pointing out that a nurse forgot to wash his or her hands, or notifying the surgical team that surgical instruments were not adequately cleaned may seem like small issues; but at the same time, not acknowledging a break in a sterile technique could mean the difference between life and death for a patient. One hospital that was struggling with high levels of infection related to surgical procedures, implemented a pre-procedure huddle as a team. This innovate way decreased the spread of infection and was a great way to improve the quality of care for patients. As mandated by the Joint commission, infection prevention personnel should provide multidisciplinary education on SSI prevention, to all team members, including
Currently, in the medical field, there is a large rate of incidence where infections are hospital acquired, or in other words a high rate of infections acquired through contact with hospital personnel or while in the hospital environment. The high rate of infections acquired has a primary source the close contact within the hospital environment of disease(s) that can be transmitted via the necessary touching done of patients by the health care workers. One study shows that many of the pathogens responsible for nosocomial infections are transmitted from patient to patient via the hands of health-care workers (Polat, Parlak, Cevik, 2011). This is true of every hospital and is an ongoing problem that has been addressed in a myriad of ways, some more effective than others.
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.
Non-compliance of correct hand hygiene can lead to severe life-threatening diseases (Malliarou, et al, 2013). Hand hygiene is one of the most effective, inexpensive and simplest ways to help prevent the spread of healthcare acquired infections (HCAIs) (Malliarou, et al, 2013). It is often recognised by healthcare professionals that they do not comply with hand hygiene as often as necessary or do not follow the correct techniques due to certain factors such as role modelling/social influences, attitude, self efficacy and also due to time constraints and level of knowledge (Wandel, et al, 2010). The effectiveness of a simple hand wash can often be underestimated by healthcare professionals (Kilpatrick, et al, 2013). Failure to comply with appropriate hand hygiene is considered to be the leading cause od healthcare acquired infections and the spread of multi-resistant organisms (Malliarou, et al, 2013). Understanding the importance and performing hand hygiene at the right time and in the correct manner is absolutely crucial to the preventing of easily avoidable healthcare acquired infections (Kilpatrick, et al, 2013). Hospital acquired infections are closely linked to increased morbidity, mortality, increased costs of healthcare and also prolonged hospital stays (Tan & Olivo, 2015).