Hand Hygiene Hospitals And Long Term Care Facilities

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).

Hospital acquired infections (HAIs) affect over 1.7 million patients each year, causing almost 100,000 deaths annually in the United States alone (Johnson, 2010). According to the World Health Organization, HAIs are the most frequent adverse event in the healthcare industry. Fortunately, most of these infections can be prevented with one single intervention, proper hand hygiene (“The Evidence,” n.d.). Four out of five pathogens that cause illness are spread by direct contact. Proper hand hygiene eliminates these pathogens and helps to prevent cross-contamination and HAIs (Linton, 2015; “Hand Hygiene,” n.d.). Reduction of cross-contamination and HAIs improves patient outcomes, increases employee wellness, and lowers health care costs. Adherence to proper hand hygiene is the single most important safety measure in the health care setting. However, for many years compliance to proper hand hygiene in the healthcare industry has been dismally low. New and inventive measures must be implemented to increase compliance to proper hand hygiene and lower the rate of hospital-acquired infections.

As we know, older residents are susceptible to infections because of multi-morbidity, greater severity of illness, functional impairment, cognitive impairment, incontinence, and the presence of frequent short-term and long-term indwelling device use such as urinary catheters and feeding tubes. For infection prevention control program, an effective infection prevention program includes a method of surveillance for infections and antimicrobial-resistant pathogens, an outbreak control plan for epidemics, isolation and standard precautions, hand hygiene, staff education, an employee health program, a resident health program, policy formation and periodic review with audits, and a policy

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.

Elimination of HAI’s are a top priority for many healthcare related organizations and as such, the reduction of certain types of HAIs have been achieved. On the national level, the HAI Progress Report states that there has been, “Au 46 percent decrease in central line-associated bloodstream infections (CLABSI) and a 19 percent decrease in select surgical site infections (SSIs) between 2008 and 2013” as well as “an 8 percent decrease in hospital-onset MRSA bacteremia and a 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013” (CDC, 2015).

This makes it difficult to determine how much HH really affects the infection rates. Maintaining HH is very difficult. This study confirms the observation that institutional adoption of a guideline does not guarantee practice changes (Larson, 2007). The reduction in central line infections and ventilator acquired pneumonia occurred in both high and low compliance hospitals which indicates that there may be other variables affecting the results.|

infections. There are many reasons for their vulnerability including frailty, pre-existing conditions, and weakened immune systems. They may not be able to fully communicate with healthcare workers to report changes in health or may be too embarrassed by their decline in health to report the changes. Because of this, it is very important for residential care workers to ensure that infection control and prevention measures are implemented. Infections can cause many unwanted side effects in patients such as pain, discomfort, disorientation, and even in severe cases death. Not all infections can be passed from person to person. However, in residential care settings, many infections that can be passed from person to

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

In regards to achieving higher value, the prevention of health -associated infections leads to better quality of life. To sustain state HAI prevention programs, these policy interventions can aid in accelerating HAI prevention by implementing a public health model. This public health model will promote adherence to evidence –based practices and focus on prevention efforts. There are several federal initiatives underway to advance HAI prevention; this allows time for states to enhance their HAI programs. Laws pertaining to HAI prevention have been passed by 32 states including the District of Columbia as of January 2011. The Affordable Care Act of 2010 and Patient Protection has placed emphasis on prevention of HAI through the CMS Hospital Inpatient Quality Reporting Program. This has created a national mandate for public reporting of HAI. Value based purchasing strategies and federal pay for performance has been implemented in 2013 through the Affordable Care Act.

More than one million of Healthcare associated infections happen across healthcare settings every year, or 1 in 20 people admitted to any healthcare setting (Healthy people 2020, 2013). HAIs are the most common complication seen in hospitalized patients. HAIs increase morbidity, mortality, healthcare costs, and length of stay even after adjustment for the main underlying illness. According to the Center for Diseases Control (CDC, April 2013) 5 to 10% of patients admitted to acute-care hospitals, or long-term care facilities approximately 2 million patients per year in the United States acquire a nosocomial infection. At least 90,000 deaths per year are a result of HAIs, making it the fifth leading cause of death in acute-care hospitals. These

Infection can be prevented in a way where it can protect the individual that are using the service. In the residential care home infection can affect more around the residential care home. Vulnerable adult will more likely to get the infection since they have a weak immune system. When the nurses around the residential home will need to make sure they follow the basic procedure that can control the infection, which can minimise the infection to themselves and others around them. From preventing infection they will have

This plan involves preventing future HAIs from happening to prevent further costs. HAIs have been estimated to cost twenty-eight to forty-five billion in excess healthcare costs (Zimlichman et al., 2013). Effective evidence based practice for infection control must be in place and all employees must comply. Healthcare administrators should use evidence based practice to implement these infection controls and make sure there are checks and balances to ensure every employee is complying with the guidelines. In addition, the healthcare administrator must make sure that the organization receives every dollar that their healthcare organization should receive from the insurance company to prevent any more loss financially. To get payment from The Centers for Medicare & Medicaid Services (CMS), hospitals are required to report data about some infections to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) ("Healthcare-Associated Infections (HAI) data", 2016). In addition, CMS has provided incentives for hospital that beat averages of HAIs at healthcare organizations. The healthcare administrator must make sure they report to the CDC’s NHSN and prevent future HAIs. Also, the administrator should thoroughly and routinely check to make sure the insurance company properly reimburses the right amount to the healthcare organization. If the healthcare administrator implements procedures to provided infection control based on evidence based practice and monitors the reimbursement process properly following correct procedures, the administrator can help the healthcare organization reduce future costs for

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

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.