Problem Identification and Background Evidence

Running Head : Hand hygiene
Hand hygiene
Name of the Student
Name of the University
Authors Note

Hand hygiene2
Problem Identification and Background Evidence
Introduction
The project plan will be focused on importance of Hand Hygiene in infection
prevention in an acute care unit of hospital. In section1, the evidence of effectiveness of the
hand-washing will be discussed. The section 2 will be represented with the proposal in detail
and summary of implementation of the plan. Evaluation and measurements will be shown in
section 3 which will help in the assessment of proposed plan. Finally, recommendations and
learning out comes will be described in the section 4.
Topic choice –rationale and reflection on practice
In my experience as healthcare assistant and during my placement of first and
second year , I have observed that the hospital acquired infection can be controlled by
hand hygiene and to control the infection among the patient and longer hospital stay .
300,000 healthcare-acquired infections are reported annually and among them 5,000 cases
outcome in mortality (Zilberberg et al., 2017). WHO has invented a hand hygiene protocol
called “5 moments of hand hygiene” which has been proven as an effective intervention for
preventing nosocomial infection in the hospital setting (www.who.int, 2020). The five steps
consist the following steps such as; “Before patient contact”, “Before aseptic task ”, “After
body fluid exposure risk”, “After touching a patient” and “After touching patient’s
surrounding”.
Background evidence

Hand hygiene3
I have investigated the usefulness of hand hygiene in preventing infection among the
patients admitted in the acute care unit in my literature review. Practice of Hand-washing
can reduce MRSA infections among the patients. Hand hygiene can prevent flu and food
poison with other diseases. There are different types of hand hygiene such as routine hand
wash, antiseptic hand wash, antiseptic hand-rub and surgical antisepsis (Bolon, 2016).
According to Gould et al., 2017, in acute care setting the highest rate of morbidity
and mortality is responsible for health care‐associated infection . Hand hygiene is one of the
most effective preventive measure to reduce Healthcare associated infection among the
patient. According to a systematic review short and long-term success policies recover the
compliance regarding Commendation of hand hygiene can determine whether hand hygiene
is effective acquiescence for reducing the rate of Health Care associated infection in in
hospitals or not. In the systematic review different studies were taken for evaluate the
effectiveness of hand hygiene compliances in Healthcare associated infection reduction. The
different strategies are education, verbal and written reminders, various performance
responses, organisational support with staff involvement and placement of alcohol based
hand rub in acute care settings.After reviewing 26 studies Systematic review state that
multimodal strategies are useful in improving hand hygiene compliances and reduce the
infection rate. The interventions are also effective in lowering methicillin-resistant
Staphylococcus aureus infection rate. The systematic review has stated that enhancing the
interventions of WHO can slightly improve hand hygiene compliances or reduce the
colonisation of bacteria and germs. However there is no use difference after executing the
WHO compliances in action of infection rate control.
Another study was conducted to evaluate the effectiveness of hand hygiene depending
upon the patient health condition and care environment(Okada, Yamamizu, and Fukai, 2016).
The study that in hemodialysis patient hand contamination rate is highest followed by the

Hand hygiene4
resident of of nursing homes patient with cancer postoperative patient and the patient of
hematological malignancies. The samples were taken from inpatient and outpatient and
individuals living in nursing home. The participants of the study perform hand hygiene and
bacteria samples were collected from the palm of the participants before and after performing
the hand hygiene procedure. The researcher collected the samples of smear from contralateral
Palm and measured the adenosine triphosphate levels to calculate the bacterial colonization.
Hand washing was more effective than using wet wipes to reduce infection rate. Regardless
the care environment and health condition of the patient hand hygiene is effective in reducing
methicillin-resistant staphylococcus aureus.
Relation between surface contact of Health Care worker and hand hygiene was studied in bye
observational study in a single bed hospital of UK. This study evaluate our relationship
between handwriting and the frequency of touching surface by Healthcare workers in a
patient room. Often the surface contact was non-random and the hygiene was deferred before
and after the patient contact (King et al.,2016). However the study showed that hand hygiene
was not related to spending time in patient room. The study represent that subconscious need
for hand hygiene has been increased among the Healthcare workers. This consciousness with
the help to support and focus on future and hygiene educational programs which will help in
patient care.
A reprospective cohort study investigated that application of hand hygiene complaints
system can resulted in to improve hand hygiene compliance and reduction in common
Hospital acquired infection rate. The trial was conducted in an Intensive Care Unit and
Intensive Care step down unit in hospital facility. The study was conducted to understand the
effectiveness of automated hand hygiene complement system in monitoring Healthcare
workers and the hand hygiene practices in in hospital care setting. The Complaints system
collected 623 404 events in comparison of 480 human observed events (McCalla et al.,