Handwashing Assignment

Steeve & Mallison (1975) stated hand hygiene has often been singled out as the most important procedure in preventing infection. Guidelines from national and international infection prevention and control organizations acknowledged that hand washing is the single most important procedure for preventing infections (Ganner and Favero,1985).

OBJECTIVE The objective for Rabie and Curtis (2006) was to determine the influence of hand washing on the risk of respiratory infection. METHOD The method adopted by Rabie and Curtis (2006) was to study a number of primary and review articles from five diverse databases before June 2004 in differing languages, to create a systematic review. Included in the review were studies which identified the impact of an intervention to promote hand cleansing on respiratory infections. Studies regarding hospital-acquired infections, long-term care facilities and the elderly were excluded. All studies were then evaluated where a conclusive decision was reached by consensus. Interestingly, from a primary list of 410 articles, only eight interventional studies reached the eligibility criteria. RESULTS The eight eligible studies disclosed that hand washing with antiseptic soap lowered risks of respiratory infection; the risk reduction identified as being from 6% to 44% and this range figures implied that hand washing can indeed reduce the risk of respiratory infection by 16% (Rabie and Curtis 2006). CONCLUSION Rabie and Curtis (2006) concluded that the studies collected were of insufficient quality and only one of the studies related to severe disease as well as none of the studies related

Before I started the assessment I used alcohol gel to decontaminate my hand. NICE (2006) states that hand must be decontaminated before each and every episode of direct patient care. It is important to decontaminate my hand to prevent cross-infection of micro-organisms from staff to patient, for example Hospital Acquired Infection. I realised that I am going to have contact with body fluid and blood therefore I put on a pair of latex gloves and disposable plastic apron. Wandsworth Teaching Primary Care Trust May (2008) states that ‘Personal Protective Equipment is designed to protect the healthcare worker from coming into contact with potentially infectious body fluids. It may also protect the patient from the healthcare workers own microbial flora’.

Dirty hands is the common source of spreading infection. It is very important to keep hands clean to avoid getting infected and spreading infection in the community. It is important to wash hands to keep hands clean. There are two ways to keep hand clean, one way is wash hands with soap and warm water while rubbing hands together for minimum 15 to 30 seconds. Indication of washing hands with soap and water is when hands are visibly dirty, before and after eating, feeding, using the toilet, after coughing or sneezing, after using gloves, taking care of patients. There is also second way to clean hands, but it is advisable to wash hands with soap and water all the time, but it can ignore when soap and water is not available so it is okay to use hand gel or foam in the form of sanitizer. This helps to clean hands or kill germs when hands are not visibly dirty.

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.

This study was intended to prove that hand hygiene practiced according to the CDC guidelines will decrease the incidence of hospital acquired infections. This could not really be proved in this study since the hospitals were not able to maintain improvement in hand hygiene. Health care workers were familiar with guidelines but significant practice changes were not maintained. Some of the infection rates did improve during this time but the correlation with hand hygiene is not consistent. There were other practice changes occurring during this same time and those changes may be responsible for the decreased infection rates.

During this last visit, Dr. M made some mistakes which may have played a crucial role in Jacob acquiring an infection, or, in the least, contributed to negligence. After removing Jacob’s cast, Dr. M did not complete his examination of Jacob’s leg before he left the room to exam another patient, Sarah, in the room across the hall. Upon entering the room, he did not close the door. The most obvious mistake the doctor did was not washing his hands after his examination of Sarah, who has osteomyelitis, after which he returned to the first exam room to continue his examination of Jacob’s leg. Hand washing plays a major role in preventing cross-contamination when caring for patients. According to the Centers for Disease Control and Prevention (CDC, 2014), washing hands is an extremely important way to prevent the spread of infection from patient to patient or patient to health care professional. It is essential that all health care providers practice hand hygiene even if gloves are worn. There

A campaign called, “Clean Hands Save Lives” endorsed by the CDC in the year 2015 put an emphasis on five simple steps to avoid or reduce illnesses. The steps are the following and to be carried out in that order: wet, lather, scrub, rinse, and dry (Potter, Perry, Stockert, & Hall, pg. 458). In addition to performing hand hygiene, gloves must also be used when handling any type of specimen. The use of PPE or Personal protective equipment is important as it protects the wearer from any type of injury or infection. (PPE) Healthcare facilities disclose the type of contact precaution outside a patient’s door. For example, a label for Airborne Precautions indicate that a respiratory protection device (N95 respirator) must be worn in order to enter the room and while interacting with the patient. A room with Droplet Precautions requires the use of a mask or respirator. On the other hand, a room with Contact Precautions indicates the use of gloves and gowns, and a room with category Protective Environment requires protection with HEPA filtration, mask, gloves, and gowns (Potter et al., pg 459).

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.

The hospital is compliant with infection control protocol according to the CDC standard guidelines. “Hand hygiene, contact precautions, as well as cleaning and disinfecting patient care equipment and the patient’s environment are essential strategies for preventing the spread of health care–associated infections. Hand hygiene is addressed in NPSG.07.01.01. Contact precautions for patients with

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

Hands were wet by a running tap and antiseptic detergents or liquid soap (5ml was poured onto the hands, the technique consisted of five backwards and forwards strokes in the motion of; palm to palm, each palm over the other hand’s back, interlocking palm to palm, each palm over the other hand’s back interlocked and then the rotational scrubbing of the fingers into each palm finalised by the rubbing of the wrists during a 30-second time span. Then the hands were rinsed with water for 15-seconds and dried with two paper towels for 15-seconds. (Ayliffe et all, 1978) Whilst this technique has strict timescales the WHO elects the timescale of roughly the time taken to sing “Happy Birthday” twice. This raises concerns over the approximates as this will differ from person to person. The procedure itself remains nearly exact except from the addition of turning the tap off with a towel to avoid recontamination and the exact timings are lost. This technique only stated to use running water, however no temperature was specified. Hand Washing for Life (200-) advises that water should not be above 110F as this temperature would cause hands become damaged by loosing delicate tissues on the skin. This can cause bacteria to become trapped and more difficult to remove, as well as cause pain to the worker. It is a legal requirement for health professions to take the necessary measures to

* Hand washing is the most important method of preventing the spread of infection by contact (Ayliffe et al 1999). The Nottingham University Trust Policy on Hand Hygiene (2009) states that there are three types of hand hygiene, the first is ‘routine hand hygiene’ which involves the use of soap and water for 15 – 20 seconds or the application of alcohol hand rub until the hand are dry. The second is ‘hand disinfection’ which should be used prior to an aseptic procedure by washing with soap and water and applying alcohol hand rub afterwards. The third is ‘surgical hand washing’ which is the application of a microbial agent to the hands and wrists for two minutes. In addition to which a sterile, disposable brush may be used for the first surgical hand wash of the day although continued use will encourage colonisation of microbes. The third example is the most appropriate to any O.D.P undertaking the surgical role as it is the best way for the surgical team to eliminate transient flora and reduce resident skin flora (World Health Organization 2010). The first and second are important to any O.D.P undertaking any other role within the Operating Department as this is the best way to reduce the transient microbial flora without necessarily affecting the resident skin flora

There are grave consequences when people do not wash their hands or wash them improperly. It is known that hands are the main media for contaminants getting to people, whether the infections are airborne, oral or tactile.