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Importance of Hand Hygiene in Healthcare

Introduction

Maintaining hand hygiene is a critical approach to prevent infections in healthcare care settings, especially inpatient settings (Mathur, 2011). However, it has been argued that healthcare personnel do not comply with rules that are used both in hand washing soap and water or hand washing with alcohol-based products. Research shows that maintenance of hand hygiene is negatively impacted by several factors, such as lack of resources, lack of knowledge among healthcare staff, and high rates of resistant bacteria, among others (Cantrell, 2008). A nursing research is critical to understand some of the problems that negatively impact healthcare outcomes in hospitals (Polit & Beck, 2012).

The PICOT question proposed is as follows: In hospitalized patients, what effect does hand washing with soap and running water compared with hand-sanitizing with alcohol-based hand sanitizer have on the incidence of infections during the hospital stay? This paper focuses on conducting a literature review that would help to determine the information that is available in relation to the research question. In addition, it would be important to identify gaps or further questions. A summary of the articles used in this review is attached as an appendix.

Literature review

Infections that are acquired by patients in hospitals are drawing much attention from various stakeholders, such as patients, healthcare workers, regulatory agencies, and governments, among others. The attention is not only as a result of remarkable mortality rates, morbidity rates, and costs involved in treatments, but also due to the realization that a large number of the diseases can be prevented (Mathur, 2011). Some of the best strategies in relation to reducing the diseases are increasing concentration on infection control approaches, equipping organizational leaders with the right knowledge, and changing the platforms on which surveillance and monitoring are conducted (Mathur, 2011).

Personnel in healthcare settings contend that educating staff about intervening to improve decontamination is crucial to prevent infections in hospitalized patients. In one of the largest hospitals in the UK, a study was conducted to assess the effectiveness of a ‘clean practice protocol’ (CPP), which was adopted from international bodies that aimed at promoting its use by surgical teams. The researchers used infection-control audits that were spearheaded by physicians in the hospitals. It was established that the of CPP regulations was critical to improve hygiene in the facility. Thus, it was concluded that the approach was one of the best ways to educate and audit personnel in relation to infection-control practices (Howard et al., 2009).

Other researchers have concentrated on providing healthcare workers with updates and recommendations on the adoption of the two strategies of decontaminating hands. Boyce and Pittet (2002) argue that recommendations should concern issues such as hand lotions, the use of artificial fingernails, and the adoption of hand antiseptics, among others (Boyce & Pittet, 2002). One of the bodies that have been involved in giving scientific-based suggestions with regard to hand washing is the WHO.

It is critical to underscore that the health body suggests that developing and developed nations should use different approaches to control hospital-acquired infections. The last recommendations from the agency were launched in 2009 with the aim of improving compliance, and introducing new tools and techniques (Mathai, Allegranzi, Kilpatrick & Pittet, 2010).

However, there are concerns that hospitals may improve hand hygiene compliance, but which would not correlate with reduction in the number of infections among patients admitted in inpatient settings. To illustrate this, a study was conducted in a teaching hospital to assess the results of using anti-bacterial hand gels to minimize hospital-acquired infections (Cantrell, 2008). The study authors indicate that there were significant improvements on the rates of hand hygiene compliance.

However, the study subjects did not show any reductions in rates of acquiring infections. It is prudent to note that anti-bacterial hand gels were the mostly widely used products in the study. A research gap exists in relation to long-term use of hand washing approaches in healthcare institutions. The study could be limited on the grounds that it was conducted within a relatively short period. In addition, it was only carried out in one facility (Cantrell, 2008).

There has been a worry that limited research data exists about continued impacts of hand hygiene programs (HHPs) that are adopted in teaching health facilities. A 4-year hospital-based study was started in 2004 in a Taiwan institution to determine the effectiveness of using alcohol-based hand rubs. The findings indicated that there were significant reductions in the number of infections among hospitalized patients. As a result, it was established that there was significant cost savings in the health facility (Chen et al., 2011). The conclusions of the study authors are in agreement with those from another study that focused on reducing the number of nosocomial infections by the use of hand washing using alcohol-based products in a hospital in Vietnam (Nguyen, Nguyen & Jones, 2008).

It was found that the approach could be cost effective and practiced with a lot of ease. In fact, the average time that patients spent in the impatient setting reduced remarkably. In addition, its outcomes could be assessed easily. A detailed review in relation to the effectiveness of alcohol-based solutions for washing hands has also indicated that the approach consumes less time, but removes more microbes in given period (Picheansathian, 2004).

Research has shown that effective hand washing does not only include the use of antiseptic agents, but also hand drying that is aimed at decreasing the number of microbes on the skin surface. It has also been argued that spending relatively long period cleaning hands does not correlate with infection control (Collins & Hampton, 2005). Risks of cross-infection can be reduced remarkably by adopting certain approaches when. For example, healthcare workers should maintain short fingernails, remove wristwatches, wear gloves when handling patients, and roll up their sleeves (Gould, 2009).

Conclusions

While the literature review in this paper indicates that hospital-acquired infections are major problems across the world, it is critical to note that inconsistencies and contradictions exist. For example, some studies have reported that cleaning hands with soap and water is more effective than the use of alcohol-based solutions. It is notable that few studies have been conducted in developing countries, yet are faced with the challenges of adopting effective methods of washing hands in healthcare facilities.

It is evident that fewer studies have been conducted on the effectiveness of using soap and water to clean hands in hospitals. The fact that more studies have been done in relation to the use of alcohol-based agents to clean hands does not merit a change in practice. In fact, preliminary conclusions would require further research to adequately address inquiry into the two approaches to wash hands.

References

Boyce, J. M., & Pittet, D. (2002). Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. American journal of infection control, 30(8), 1-46.

Cantrell, S. (2008). Infection control update. Hospital study shows improvement in hand hygiene compliance but no reduction in infection rates. Healthcare Purchasing News, 32(3), 22-24.

Chen, Y. C., Sheng, W. H., Wang, J. T., Chang, S. C., Lin, H. C., Tien, K. L.,… & Tsai, K. S. (2011). Effectiveness and Limitations of Hand Hygiene Promotion on Decreasing Healthcare–Associated Infections. PloS one, 6(11), 1-9.

Collins, F., & Hampton, S. (2005). Hand-washing and methicillin-resistant Staphylococcus aureus. British journal of nursing, 14(13), 703-707.

Gould, D. (2009). Infection control: hand hygiene. British Journal of Healthcare Assistants, 3(3), 110-113.

Howard, D. P. J., Williams, C., Sen, S., Shah, A., Daurka, J., Bird, R.,… & Howard, A. (2009). A simple effective clean practice protocol significantly improves hand decontamination and infection control measures in the acute surgical setting. Infection, 37(1), 34-38.

Mathai, E., Allegranzi, B., Kilpatrick, C., & Pittet, D. (2010). Prevention and control of health care-associated infections through improved hand hygiene. Indian journal of medical microbiology, 28(2), 100-106.

Mathur, P. (2011). Hand hygiene: back to the basics of infection control. The Indian journal of medical research, 134(5), 611-620.

Nguyen, K. V., Nguyen, P. T. M., & Jones, S. L. (2008). Effectiveness of an alcohol‐based hand hygiene programme in reducing nosocomial infections in the Urology Ward of Binh Dan Hospital, Vietnam. Tropical Medicine & International Health, 13(10), 1297-1302.

Picheansathian, W. (2004). A systematic review on the effectiveness of alcohol‐based solutions for hand hygiene. International journal of nursing practice, 10(1), 3-9.

Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA. Lippincott Williams & Wilkins.

Appendix

Citation Type of Study

Design Type

Framework/Theory

Setting Key Concepts/Variables Findings Hierarchy of Evidence Level
Howard, D., Williams, C., Sen, S., Shah, A., Daurka, J., Bird, R., &… Howard, A. (2009). A simple effective clean practice protocol significantly improves hand decontamination and infection control measures in the acute surgical setting. Infection, 37(1), 34-38. Web.

Nguyen, K., Nguyen, P., &Jones, S. (2008). Effectiveness of an alcohol-based hand hygiene programme in reducing nosocomial infections in the Urology Ward of Binh Dan Hospital, Vietnam. Tropical Medicine &International Health: TM &IH, 13(10), 1297-1302.

Type of Study:
QuantitativeDesign Type: Prospective

Framework/Theory:
None

Type of Study: Quantitative

Design Type: Prospective

Framework/Theory
None

Surgical setting

Urology ward

Concepts: Hand washing protocol and control measures

Independent Variable: Protocol

Dependent Variable: Infections

Controlled Variable: None

Concepts: Use of alcohol-based solutions to wash hands

Independent Variable: Alcohol-based solutions

Dependent Variable: Nosocomial infections

Controlled Variable: None

The hygiene
Protocol was
effectiveThe approach
Was relatively
Effective
High

High

Chen, Y., Sheng, W., Wang, J., Chang, S., Lin, H., Tien, K., &… Tsai, K. (2011). Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections. Plos One, 6(11), e27163. Web.

Cantrell, S. (2008). Infection control update. Hospital study shows improvement in hand hygiene compliance but no reduction in infection rates. Healthcare Purchasing News, 32(3), 22-24.

Boyce, J. M., &Pittet, D. (2002). Guidelines for Hand Hygiene in Health-Care Settings. (Cover story). MMWR: Morbidity &Mortality Weekly Report, 51(42), 1.

Mathai, E., Allegranzi, B., Kilpatrick, C., & Pittet, D. (2010). Prevention and control of health care-associated infections through improved hand hygiene. Indian Journal Of Medical Microbiology, 28(2), 100-106. Web.

Mathur, P. (2011). Hand hygiene: back to the basics of infection control. The Indian Journal Of Medical Research, 134(5), 611-620. Web.

Collins, F., &Hampton, S. (2005). Infection control. Hand-washing and methicillin-resistant Staphylococcus aureus. British Journal Of Nursing, 14(13), 703-707.

Picheansathian, W. (2004). A systematic review on the effectiveness of alcohol-based solutions for hand hygiene. International Journal Of Nursing Practice, 10(1), 3-9.

Chen, Y., Sheng, W., Wang, J., Chang, S., Lin, H., Tien, K., &… Tsai, K. (2011). Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections. Plos One, 6(11), e27163. Web.

Type of Study: Quantitative

Design Type: Prospective

Framework/Theory: None

Type of Study: Quantitative

Design Type: Prospective

Framework/Theory: None

Type of Study: Review

Design Type: Retrospective

Framework/Theory: None

Type of Study: Prospective

Design Type: Prospective

Framework/Theory: None

Type of Study:

Design Type:

Framework/Theory

Type of Study: Qualitative

Design Type: Retrospective

Framework/Theory: None

Type of Study: Quantitative

Design Type: Prospective

Framework/Theory: None

Type of Study: Review

Design Type: Retrospective

Framework/Theory: None

Type of Study: Quantitative

Design Type: Cross-sectional

Framework/Theory: None

Inpatient

Inpatient

Inpatient

Inpatient

Inpatient

Inpatient

Inpatient

Inpatient

Concepts: Hand hygiene promotion
Independent Variable: Education
Dependent Variable:
Controlled Variable: NoneConcepts:
Compliance and infections

Independent Variable: Hygiene compliance

Dependent Variable:
infections

Controlled Variable: None

Concepts:
Compliance and reduction of infections

Independent Variable: Compliance

Dependent Variable: Infections

Controlled Variable: None

Concepts:
Guidelines
Independent Variable: None
Dependent Variable: None

Controlled Variable: None

Concepts: Prevention and control measures

Independent Variable: Hand hygiene
Dependent Variable: Infections
Controlled Variable: None

Concepts: Basics of infection control

Independent Variable: None
Dependent Variable: None
Controlled Variable: None

Concepts: Infection control and antibiotics
Independent Variable: Number of microbes
Dependent Variable: Infections
Controlled Variable:

Concepts:
Alcohol-based solutions
Independent Variable: None
Dependent Variable: None
Controlled Variable: None

Concepts:
Alcohol-based solutions
Independent Variable: None
Dependent Variable: None
Controlled Variable: None

Wellbeing improved

Compliance improved, but infections not reduced

Improved outcomes

Improved hand hygiene

Improved hand hygiene

Better hand hygiene

Improved hand hygiene

Improved hand hygiene

High

High

Low

High

High

High

High

High

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StudyKraken. (2022, August 26). Importance of Hand Hygiene in Healthcare. Retrieved from https://studykraken.com/importance-of-hand-hygiene-in-healthcare/

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1. StudyKraken. "Importance of Hand Hygiene in Healthcare." August 26, 2022. https://studykraken.com/importance-of-hand-hygiene-in-healthcare/.


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StudyKraken. "Importance of Hand Hygiene in Healthcare." August 26, 2022. https://studykraken.com/importance-of-hand-hygiene-in-healthcare/.

References

StudyKraken. 2022. "Importance of Hand Hygiene in Healthcare." August 26, 2022. https://studykraken.com/importance-of-hand-hygiene-in-healthcare/.

References

StudyKraken. (2022) 'Importance of Hand Hygiene in Healthcare'. 26 August.

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