Waiting for Wings Hospital Policy for Hand and Fingernail Hygiene Guidelines
Purpose:
This Waiting for Wings Hospital (WFWH) policy provides evidence-based principles and practices necessary for persons to accomplish proper hand and fingernail hygiene. This policy follows guidelines set forth by the Centers for Disease Control (CDC) in an attempt to reduce healthcare-associated infection (HAI) that are spreads to patients, staff, and others.
Scope:
This policy applies to and must be adhered by all employees of WFWH including allied health professionals, students, credentialed specialists, and contractors. Patients, family members, and visitors will be encouraged to follow these guidelines. Educational material will be provided in an attempt to improve understanding of the importance of good hand and nail hygiene for the prevention of healthcare-associated infection.
Background:
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
Outside of the actual act of washing your hands, the easiest step in cleanliness is not wearing any jewelry. Regardless if it is removed prior to handwashing, jewelry is prohibited for all staff who come in contact with patients as it is possible for micro-organisms to survive on the jewelry (Western University 21). Furthermore, although it is hard to know if bacteria is present, long nails and/or the use of nail polish increases the places that bacteria can be harboured (Western University 21). Lastly, the best way to protect and care for you and your patients is by simply washing your hands. When doing so, lather your hands for 15 seconds with soap, thoroughly rinse off with warm water, then dry your hands and turn off the tap with paper towel. This must be done both before and after any contact with a patient, regardless of the scenario. Moreover, if applicable, must also be washed before any aseptic procedures as well as after exposure to any bodily fluids. As an alternative to hand washing the London Health Science Centre has installed an increased amount of alcohol based rub dispensers throughout its locations (Western University 22). Thus, in an attempt to increase access and reach compliance goals for patients, staff, and visitors. These rubs may be used as long as there is no visible dirt, food or other substances on your hands. To properly sterilize your hands ensure that hands are rubbed together until all of the solution dissolves and hands are dry. The following methods are not only essential protocol for all staff to follow but are the best way to prevent the spread of
Nurses can provide printed patient safety guidelines for patients and their families to follow so that patients may proactively perform extra cleanliness in preoperative preparation; also raise caregivers’ awareness of hand hygiene prior to performing procedures (Skoufalos et al., 2012). In addition, as antibiotic
Hand hygiene is the most effective way of preventing the spread of infections. Most hospital-acquired infections are spread via the hands of the healthcare workers. According to the CDC, about 2 million or 1:20 patients are infected with a hospital acquired infection. Hand washing includes washing hands with warm water and soap or antiseptic hand sanitizers. (book, 540) Programs have be developed to observe the nurses, doctors, and other NICU workers to see if they were following the current hand hygiene guidelines. In this program faculty was observed for a baseline assessment then given a questionnaire asking the employees what they knew about hang hygiene. The assessment was monitored by nurses that were trained in hand hygiene and observation
Hand hygiene compliance is very relevant in health care. At study by Creel (2015) evaluates whether or not monitoring interventions improve hand hygiene compliance (Creel, 2015). Healthcare-associated infections (HAIs) can be detrimental to not only patients but also visitors, workers, and families. Considering the fact that most patients in the hospital are highly susceptible of having compromised immune systems, it is imperative that healthcare professionals take the proper necessary precautions, such as effective hand hygiene, to decrease the risk of transmission. This is a cost effective management of infection control that can potentially save lives.
"An estimated 2.5 million hospital-acquired infections occur annually in the United States" (Fox et al., 2015). Hospital acquired infections (HAIs) are defined as infections that are associated with interventions, devices or procedures carried out in healthcare facilities (Aziz, 2014). Of these 2.5 million HAIs, 90,000 patient deaths result that were completely preventable (Fox et al., 2015). These infections are considered to be entirely avoidable if health care workers adhere to proper infection control guidelines. One of the most significant ways of preventing infection in a health care setting is proper hand hygiene. Hand hygiene has been accepted as the single most important measure to prevent the spread of infection and is the foundation of most infection prevention and control programs (Grota, Ackiss, & Association for Professionals in Infection Control and Epidemiology, 2014). Nurses are the individuals who interact with patients the most; therefore, it is crucial that nurses follow proper hand hygiene practices in order to prevent the occurrence of HAIs. Although there is an abundance of evidence that HAIs cause a substantial amount of preventable morbidity and mortality, nurses often view them as far less of a threat to patient safety than other adverse events such as falls and medication administration errors. As a result of this mentality, 2.5 million HAIs occur in the United States every year. Proper hand
When there are new guidelines and teaching in regards to hand hygiene it is important to involve patients so they become aware and contribute to improve their health as they will be practicing hand hygiene. The World Health Organisation (WHO, 2009) states that healthcare providers, care homes and hospitals have an obligation of making sure that patients are educated in various ways it can be by giving them leaflets to read or by showing them videos in their wards of hand hygiene practices that demonstrates how to wash hands properly, that will improve compliance among members of staff and patients. Communication is central to successful caring relationships, it brings people together and enables improvement amongst staff in the way they care for people. It is only through good communication at any work place environment that enables people to get to know things, without good communication patients and carers will lack the understating of how to prevent healthcare, associated infections HCAI (De Bono, Heling and Borg, 2014, pp.
Hand hygiene is recognized by infection prevention and control experts as the single most important intervention in decreasing the spread of infection in both healthcare and community settings. Because the hands are vectors for transmission between people as well as inanimate objects such as environmental surfaces (i.e., blood pressure cuffs), it is critical to practice frequent hand hygiene using the traditional soap and water or an alcohol-based hand rub as appropriate. The 2009 World Health Guidelines for Hand Hygiene for Healthcare Settings identifies five ways the nosocomial transmission of pathogens from one patient to another via a healthcare worker's hands can occur:
The topic for the lesson plan revolves around primary prevention, particularly hand washing and the hospital acquired infections. Hand hygiene done correctly will reduce or eliminate health care–associated infections (World Health Organization, 2008). According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) acknowledge poor hand hygiene to be one of the most significant contributors to infections (The Joint Commission, 2009). This was a brief teaching lesson running between 20 to 30 minutes at the University of California San Diego which the community hospital for San Diego. The community in this context and the target students involved three staff nurses, first and
Hand washing has been proven to be one of the most effective means of preventing the spread of infection in healthcare facilities (Centers for Disease, 2015). An outpatient dialysis facility noted that staff was very complacent about hand hygiene. The Joint Commission National Patient Safety Goal 7 (JCPSG) states” that healthcare organizations must perform an accurate “baseline assessment of hand hygiene in order to identify opportunities for improvement” (The Joint Commission, 2016). 90,000 people die each year from hospital acquire infections at about a cost of 4.5 billion dollars (Fairchild, 2009). By increasing hand hygiene compliance could save this facility many dollars and not only that many precious lives.
The identification of several risk factors associated with poor hand hygiene compliance is of extreme importance in the design of an education program .There should be continues education and monitoring of healthcare worker on effective hand washing and hand hygiene. According to an outcome of a study, wearing finger ring, wrist watch, long fingernail and use of hand lotion has impact on spread of infection by healthcare workers (Fagemes &Lingaas 2010. Health care workers that use wrist-watches at work may cause or promote higher total bacteria count than not wearing a watch. A similar situation occurs with finder ring and health care workers should remove finger rings and watches when at work, fingernails should be shorter than 2 mm, so as to reduce HAI (Fagemes &Lingaas 2010).
Hand washing is one of the easiest and most effective ways to stop the spread of germs that can make people sick. From colds to H1N1 flu to food-borne bacteria, good hand washing practices help keep employees, patients and family members healthier. It is essential to provide patient care in a safe and clean environment, where the risk of them acquiring an infection is kept as low as possible. The hands of practice staff are the most important vehicles of cross infection. The hands of patients can also carry microbes to other body sites, equipment and staff. Hand hygiene is one of the most important methods of preventing health-care associated infections (HCAI). The problem of HCAI needs to be emphasized not only because of the large number of patients affected every year, but also for its significant impact in terms of prolonged hospital stay, attributable mortality, and other complications, as well as excess costs.
As part of the training, all patients and their families will be briefed on the importance of proper hand hygiene. This will be done on admission on the unit and as needed during their stay on the unit. The patients will be asked to speak up and remind any staff to follow proper hand hygiene before providing clinical care. Patient involvement will also be used at the evaluation stage through feedbacks on hand hygiene performance by the staff.
The National Institute for Health and Care Excellence (NICE, 2012) guidelines state that misconceptions about hand hygiene in relation to infection control are still being reported and that effective hand decontamination is still not collectively practiced, despite a vast improvement in recent years. This means that although many execute good practice, there are still healthcare workers who are putting patients at risk by not following the recommended procedure.
Healthcare workers’ hands are the most common vehicles for the transmission of microbes, causing health care associated infections, from patient to patient and within the healthcare environment. It is estimated that 50% of health care associated infection occurs due to hand of health care providers (HCPs). Hence, hand hygiene is the leading measure for preventing the spread of antimicrobial
Several studies on hand hygiene in healthcare setting have simply and broadly described compliance in terms of before and after patient care activity.9,10,11 This approach falls short of describing the most important indications for hand hygiene during the sequence of care. For instance, the “after” moments for hand hygiene involve three key indications for hand hygiene during any patient care activity i.e. after touching the patient, after touching the patient’s environment and after exposure to patient’s body fluids. This study was designed to study compliance with hand hygiene with a view of describing compliance with each of the key moments for hand hygiene during routine patient care activity.