Hand Hygiene and Evidence

Running Head: Evidenced based practice
Hand Hygiene and evidence based practices
Name of the Student
Name of the University
Authors Note

Hand Hygiene and Evidence Based Practice1
Introduction
Hand washing is an integrating part of hygiene practice in the healthcare system. The
nursing professional and health workers transmit most infectious germs. Healthcare
associated infection has been observed 1 in 25 hospitals patients per day (Kritsotakis et al.
2017). Transmission of the infectioncan be occurred during the administration of medication
and critical care treatment. Hand hygiene can decrease the rate of hospital-acquired infection
in the patients and necessary for maintaining theinfection free work environment for both the
patients and healthcare workers (Sahoo et al. 2018). Hand hygiene can be maintained by
using gloves and different compliances established by the WHO and different countries
(Santosaningsih et al. 2017). There are different levels of hand hygiene levels such as social
or routine hygiene, surgical hand hygiene and antiseptic hygiene. There are several ways to
reduce infection among the patients or the healthcare workers such as alcohol based hand
sanitizers, soap and water and antibacterial solutions. There are many international and
national compliances, which explain the procedure of hand washing. It has been observed
that different hand hygiene techniques are important to maintain the clean environment of the
hospital.
In healthcare industry, “5 moments of hand hygiene” is one of the most appropriate
hand washing compliances (Lary et al. 2018). Healthcare professionals are prone to transmit
infections in the patients during their hectic schedule. Health professionals wash hands before
entering the patient’s ward and after exiting from the room and this practice of hand washing
is known as “in and out method’’(Han &Jeong 2016). There are several steps, which can be
helpful for maintaining health and safety of the patients and the staff members in hospitals.
“In and out method” is not effective as the “5 moments of hand hygiene” (Boyce 2019). The
later method consists of 5regulatory moments should be included during the treatment of the

Hand Hygiene and Evidence Based Practice2
patients. The five moments of hand hygiene is important as hygiene practices are involved in
various steps of treatment procedure.
The steps are:
Washing hands before touching the patients: Healthcare professionals should wash their
hands before touching the patients. Although they are exposed to the clothes and personal
objects of the patients. As a result, they may encounter with the harmful microorganisms,
which could be responsible for the Hospital Acquired Infections.
Cleaning hands before treatment procedures: Before starting surgery or any clinical
procedure, the health workers should wash their hands to prevent the infection to be
transmitted to the patients.
Cleaning hands after the treatment or exposure to the bodily fluids: during any clinical
procedure, the health workers must wash their hands as they can come in contact of saliva,
blood, tears, urine and other bodily fluids of the patients.
Washing hands after directly touching the patients: As per the above-discussed points of
5 moments of hand hygiene, it has been observed that a threat of transmission of various
infections are common during direct contact with patients.
Cleaning hands after touching the patient’s surroundings: The healthcare workers are
exposed to the surroundings of a patient such as bed linens, bed rail, IV stands and other
equipment. This exposure can act as source of infection in hospital admitted patients.
The assignment focuses on critical appraisal of articles and these will help to ensure
the quality of the treatment procedure and related articles. The assessment will take place
with the help of PICO questions. The PICO framework uses to create relevant questions and
influences the literature for assessment of the Evidence Based Practice of healthcare industry

Hand Hygiene and Evidence Based Practice3
(Speckman & Friedly 2019). The full form of PICO is Population, Intervention, Comparison
and Outcome. The PICO question are used for better assessment and the possibilities of a
particular problem. The question guiding this evidence review is “In acute care unit of a
healthcare sector, 5 moments of hand hygiene is more effective in reducing Hospital
Acquired Infections among the patients?”
The elements of this PICO question are;
P (Population) - Patients admitted to the hospitals
I (interventions) – Practice of “5 Moments of Hand Hygiene”
C (Comparison) – Poor hand hygiene practices
O (Outcome) – Decrease the amount of infection among the patients admitted to the hospitals
Evidence Search Strategy
The articles are selected from the web based electronic databases such as Google
Scholar, PubMed, CINAHL etc.
The searching strategy was involved ‘AND’, ‘OR’, ‘+’ as the Boolean expressions.
To search the appropriate articles some specific keywords are used. The keywords are“hand
hygiene”, “hand washing”, “5 moments of hand hygiene”, “hospital acquired infection”,
“nurses”, “healthcare” etc..
The inclusion criteria of search strategy are
 The articles, which are written in English
 The keywords should be included in the articles
 Only peer-reviewed and scholarly articles are included
 Articles should be published within 5-10 years