Analysis of Hand Hygiene Practices and Policies

This assignment requires a comprehensive analysis of hand hygiene practices and policies in healthcare settings. It involves reviewing various resources, including systematic reviews, clinical trials, and online articles, to understand the current state of hand hygiene in healthcare. The assignment aims to provide insights into the importance of hand hygiene in preventing infections, promoting a culture of safety, and ensuring accountability among healthcare professionals.

HAND HYGIENE

Table of Contents
INTRODUCTION..........................................................................................................................................................1
MAIN BODY..................................................................................................................................................................1
Critical Understanding of professional issues underpinning care provided by Hand Hygiene.................................1
Critical Discussion and Debate of Evidence relating to how hand hygiene should be undertaken..........................2
Critical Evaluation of Potential Influence of Psychological, Social, Cultural Factors.............................................4
CONCLUSION...............................................................................................................................................................5
REFERENCES................................................................................................................................................................7

INTRODUCTION
Hand Hygiene is a practice adopted by professionals within healthcare
sectors to effectively prevent contamination of the environment and spreading of
harmful infections (Gould & et. al., 2017). It is one of the most crucial measures to
be adopted within a healthcare setting to appropriately reduce possibilities of care-
associated infections. The following report is based on hand hygiene practices
within healthcare settings. It covers a critical understanding of professional issues
which underpin the care provided in relation to hand hygiene and a critical
discussion and debate of the evidences related to how Hand Hygiene should be
undertaken. The report also includes critical evaluation of potential influence of
psychological, social as well as cultural factors impacting nursing care when
undertaking hand hygiene.
MAIN BODY
Critical Understanding of professional issues underpinning care provided by Hand
Hygiene
Within Healthcare sector, it is crucial for practitioners to take effective
measures to promote sanitation and safety within their organisations to ensure
proper care delivery to patients. One such aspect is hand hygiene. This refers to
several practices related to sanitation of hands which are necessary to ensure a safe
environment for patients and other individuals within healthcare organisations
(Hand Hygiene in Healthcare Settings, 2018). Critically, it is quite evident that
hand hygiene would reduce risks of spreading and cross-transmission of several
infections.
As per Kingston, O'Connell & Dunne, 2016, these practices are considered
as one of the most crucial factors of infection controlling in healthcare. There are
several reasons which makes it essential for healthcare organisations to consider
1

immediate and consistent implementation of hand hygiene practices. These reasons
are health care associated infections (HCAI), pathogen infections and various other
illnesses associated with providing treatment to their patients. (Hand hygiene: Back
to the basics of infection control, 2019).
Hand hygiene is one of the simplest, most important as well as least
expensive way to reduce Health Care Associated Infections as well as other form
of infections associated with healthcare. However, there are several professional
issues which underpin care provided to patients in relation to hand hygiene. One of
the major professional issues is protection of patients from harm. Critically, failure
in adopting these practices would result in enhancing problems like HCAI, which
indicates important ethical implications and reflects on health of patients as well as
organisations' system. Healthcare Associated Infections are the outcomes of
antibiotic-resistant bacteria or through transmission of viruses through non-
sanitised hands (Infection control, ethics and accountability, 2019). Another
professional issue is provision of safe environment to patients. Apart from giving
care, healthcare professionals are required to maintain a safe, healthy and clean
environment within their organisations. Hand hygiene is crucial to maintain
professional standards of clean environment that has a positive impact on the care
provided to patients. However, not following this practice might result in failure of
accomplishing appropriate standards of safe environment provided to the patients.
Critical Discussion and Debate of Evidence relating to how hand hygiene should
be undertaken
It is of vital importance for healthcare professionals to undertake hand
hygiene practices and establish a healthy culture within their organisations. It is
very essential to be adopted which would help these professionals to provide
effective care to the patients, along with adherence to hand hygiene practices. It is
2

because there are various organisms which are observed on healthcare employees'
hands after their contact from patients such as Klebsiella spp., Clostridium difficile
and Staphylococcus aureus (Infection prevention in hospitals: The importance of
hand hygiene, 2018). Thus, hand hygiene is important to reduce facilitation of
these bacteria.
However, a critical discussion and debate about adoption of hand hygiene
practices should help healthcare organisations to effectively adopt this aspect while
providing care. For instance, organisations should encourage practice of hand
washing amongst their healthcare professionals. There must be specific instances
where these professionals should use hand wash to effectively clean their hand.
Examples of such instances are, beginning of shift, approaching patients, after their
contact, following gloves removal, etc. (Hand Hygiene, 2019). While this method
could be quite appropriate to ensure a proper caring of patients in relation to hand
hygiene, more effective methods should be taken into consideration by healthcare
organisations. One effective method is alcoholic hand-rubs and sanitizers, which
must be provided to healthcare professionals for every-day use. One major benefit
of the alcohol-based hand rubs is that it is more effective than soap for clinical
settings as professionals tend to work in sterile settings, requiring them to clean
their hands more often. Another reason for the using alcohol-based hand rubs is
that it could be conveniently used by professionals in any setting despite
availability of soap and sink to wash hands. There are several guidelines set out by
National Institute for Care Excellence (NICE), in relation to hand hygiene. For
instance, the institution effectively weighs on implementing local arrangements in
order to ensure that facilities are made available in relation to hand
decontamination. Furthermore, the institution is also working towards effectively
accomplishing ensuring that local arrangements are made regarding provision of
training to healthcare professionals and supervision for adherence to hand hygiene
3

(Infection prevention and control, 2018). Furthermore, another institute Royal
College of Nursing led out guidelines for hand hygiene processes. It also includes
all the guidelines related to when and how hand hygiene must be performed.
However, system adopted by nice us more effective in comparison to hand
hygiene. Furthermore, it focuses on monitoring which further enhances its
suitability and effectiveness for healthcare organisations.
Another prominent method through which hand hygiene could be
undertaken is through provision of training within the company. Healthcare
Professionals could be properly trained in adopting hand hygiene practices by
effective methods, such as exposing themselves to demonstrations, presentations,
or effective fluorescent dye-based training techniques, etc. This would allow them
to effectively enhance the scope up to which, hand hygiene practices are adopted
within a healthcare setting (HAND SANITIZER VS SOAP AND WATER – WHICH
IS BEST?, 2019). There are several advantages of providing such training sessions
and educational programmes to professionals in ensuring accomplishment of
establishing hand hygiene culture within an organisation. However, a better
approach through which the organisations could more effectively enhance these
practices is by implementing on-the-job training methods. This training method has
several advantages for organisations as it helps them in appropriately
implementing hand hygiene practices. For instance, immediate actions could be
taken which would ensure proper adherence to these aspects. Moreover, it could
also help healthcare staff in learning methods and importance of hand hygiene
while providing healthcare which would result in a proper following of hand
hygiene practices. A systematic approach would be provided by these methods if
healthcare settings follow this aspect effectively (Hand Hygiene: Infection
Control/Exposure Control Issues for Oral Healthcare Workers, 2019).
4

As per Dai & et. al., 2015, undertaking hand hygiene for care provided to
patients is utmost necessary to facilitate cleanliness and safety along with
compliance of pre-set ethical standards related to providing effective care to
patients. Decision-making in relation to hand hygiene practices within healthcare
organisations is very necessary. To attain this, these settings should implement
certain policies which ensure adherence to hygiene and assure consistency in
providing a healthy and safe environment to their patients. One such policy which
should be implemented within the organisational settings within healthcare settings
is setting up penalties for non-adherence in following hand hygiene practices.
These penalties would develop a sense of responsibility in healthcare workers to
maintain hand hygiene standards. Moreover, according to Srigley & et. al., 2015,
another policy related to hand hygiene should be regular monitoring and routine
checking of employees in relation to maintaining hygienic standards. Furthermore,
using gloves for any surgical work and using apparatus must be made mandatory
for professionals. For acquisition of gloves, only those suppliers must be selected
who are authorised by government and provide quality approved products which
would help in keeping the hygiene consistent while providing care to patients
(Hand Hygiene Policy, 2019). Out of these policies, using sanitizers and gloves are
very effective and could help in maintaining hygiene while treating patients,
however, there are some policies which must be reviewed again and must be
applied effectively to ensure proper management of hand hygiene practices. For
instance, regular monitoring of these practices would ensure proper adherence to
these standards, however, despite of this, there is a wide scope of in-adherence in
adoption of hand hygiene. This policy should be modified through providing
education and proper training to ensure ethical standards being followed in relation
to hand hygiene. Another policy which have limitation is imposing penalties onto
5

staff for not applying hand hygiene methods. While this would make it compulsory
to follow hand hygiene standards, this policy might discourage employees and
induce an ineffective working environment. Thus, instead of following the method,
government guidelines such as washing hands after visibly dirty hand or when
soiled with blood and other body fluids and using alcohol-based hand rubs as a
preferred means for hand hygiene must be implemented within the settings (WHO
Guidelines on Hand Hygiene in Health Care, 2019). to ensure that each employee
adopt hand hygiene practices effectively within the organisation. Undertaking
aspects like following government guidelines and policies related to hand hygiene
would ensure proper treatment to patients. In addition, it would help healthcare
organisations in providing a safe and healthy environment which would foster
growth and improvement in conditions of the patients.
Critical Evaluation of Potential Influence of Psychological, Social, Cultural Factors
There are several factors which influence healthcare professionals while
providing health and social care. These factors have a huge impact on the nursing
care provided to patients and are necessary to be understood in order to effectively
manage hand hygiene practices within health and social care.
One such factors is Psychological. Emotions and psychological well-being
play a crucial role in adopting hand hygiene routine. Psychological determinants
such as various emotions like empathy are effective drivers of hand hygiene. As
per the research undertaken by Sassenrath & et. al., 2016, the degree up to which
emotional empathy is driven within the organisation plays quite a severe role in
promotion of these activities. For instance, if emotional empathy is low within the
organisation, employees tend to be careless in adoption of hand hygiene practices.
However, increase in emotional empathy also increases hand hygiene adherence
and influence behaviour of healthcare workers in adopting these practices.
6

Social Factors also influence healthcare provided to patients in relation to
hand hygiene. There are several social influencers which promotes or discourages
hand hygiene practices within healthcare. For instance, if perceptions of social
circles of individuals promotes hand hygiene, they tend to effectively follow this
practice daily in healthcare. On the contrary, discouragement and negative
perceptions related to hand hygiene discourages this practice. Same goes for
organisation in which the healthcare professional is working in. As an example, a
consistent adherence to hand hygiene practices within organisation would
influence employees in adopting these practices as their actions would be highly
influenced by actions of others (Workplace Culture Impacts Hand Hygiene
Compliance, 2018). Thus, social factors tend to influence healthcare employees in
adoption of hand hygiene practices and makes it necessary for organisations to
follow these practices for its adherence.
Cultural, in addition, also plays a crucial role for individuals to adopt hand
hygiene practices. Perhaps one of the major influencers in respect to hand hygiene,
this has a major impact on nursing care provided by individuals. Religion and
culture have huge consequences on adoption and adherence to hand hygiene.
Culture as well as religion have strong influence on the treatment provided by
healthcare workers. For instance, in various cultures in Asia, like Hinduism,
alcohol application is not promoted and hence, it would discourage usage of
alcohol-based hand rubs. However, various cultures such as Western culture take
these practices very seriously, and consider them important in their adherence to
hand hygiene (Religion and culture: Potential undercurrents influencing hand
hygiene promotion in health care, 2019).
All the factors mentioned above have a certain degree of influence on the
healthcare provided to patients in relation to hand hygiene. However, the degree up
to which these factors influence differ. For instance, cultural factors have most
7

influence on adherence of hand hygiene. This is because an individual is grown up
into that environment since birth and thus, its influencing rate is quite high. Where
psychological factors are concerned, a sense of empathy could be developed which
encourages them to promote hand hygiene. As for social factors, proper education
and training could also encourage these practices within health and social care
settings. However, all these factors are important to be considered in provision of
hand hygiene to patients to mould organisational systems which encourages its
productivity within health and social care.
CONCLUSION
This could be concluded from information presented above that hand
hygiene is very much important to be adhered and adopted in healthcare settings.
This would help in future professional practice as it would enhance the scope of
care provided to patients. In addition to this, it would effectively help in enhancing
professionalism in provision of care to patients. Furthermore, hand hygiene
adherence would also help in encouraging others within healthcare settings to
adopt the same which would provide a safe and healthy environment to patients.
For future, it is imperative that various skills are developed which are necessary for
adherence to hand hygiene. For instance, attention to detail in adoption of
measures related to hand hygiene is one skill that would help professionals in
adhering to hand hygiene. Moreover, another skill is motivation which effectively
would assist senior professionals in encouraging the establishment of an
environment where healthcare employees consistently comply with hand hygiene
practices.
8

REFERENCES
Books and Journals
Dai, H., and et. al., 2015. The impact of time at work and time off from work on rule
compliance: the case of hand hygiene in health care. Journal of Applied Psychology.
100(3). p.846.
Gould, D.J., and et. al., 2017. Interventions to improve hand hygiene compliance in patient care.
Cochrane database of systematic reviews. (9).
Kingston, L., O'Connell, N.H. and Dunne, C.P., 2016. Hand hygiene-related clinical trials
reported since 2010: a systematic review. Journal of Hospital Infection. 92(4). pp.309-
320.
Sassenrath, C., and et. al., 2016. A person-oriented approach to hand hygiene behaviour:
Emotional empathy fosters hand hygiene practice. Psychology & health. 31(2). pp.205-
227.
Srigley, J.A., and et. al., 2015. Hand hygiene monitoring technology: a systematic review of
efficacy. Journal of Hospital Infection. 89(1). pp.51-60.
Online
Hand Hygiene in Healthcare Settings. 2018. [Online] Available Through:
<https://www.cdc.gov/handhygiene/index.html>
Hand Hygiene Policy. 2019. [Online] Available Through: <https://infectioncontrol.ucsfmedicalcenter.org/12-hand-
hygiene-policy>
Hand hygiene: Back to the basics of infection control. 2019. [Online] Available Through:
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/>
Hand Hygiene: Infection Control/Exposure Control Issues for Oral Healthcare Workers. 2019. [Online] Available
Through: <https://www.dentalcare.com/en-us/professional-education/ce-courses/ce353/strategies-to-
improve-hand-hygiene-practices>
Hand Hygiene. 2019. [Online] Available Through: <https://www.gosh.nhs.uk/health-professionals/clinical-
guidelines/hand-hygiene>
HAND SANITIZER VS SOAP AND WATER – WHICH IS BEST?. 2019. [Online] Available Through:
<https://b4brands.com/blog/hand-sanitizer-vs-soap-and-water-which-is-best/>
Infection control, ethics and accountability. 2019. [Online] Available Through:
<https://www.mja.com.au/journal/2009/190/12/infection-control-ethics-and-accountability>
Infection prevention and control. 2018. [Online] Available Through:
<https://www.nice.org.uk/guidance/qs61/chapter/Quality-statement-3-Hand-decontamination>
Infection prevention in hospitals: The importance of hand hygiene. 2018. [Online] Available Through:
<https://www.healio.com/infectious-disease/nosocomial-infections/news/print/infectious-disease-news/
%7Bdd1e115b-8a00-4889-9e85-8566391f2541%7D/infection-prevention-in-hospitals-the-importance-of-
hand-hygiene>
Religion and culture: Potential undercurrents influencing hand hygiene promotion in health care. 2019. [Online]
Available Through: <https://www.ajicjournal.org/article/S0196-6553(08)00489-6/pdf>
WHO Guidelines on Hand Hygiene in Health Care. 2019. [Online] Available Through:
<https://www.ncbi.nlm.nih.gov/books/NBK144035/>
Workplace Culture Impacts Hand Hygiene Compliance. 2018. [Online] Available Through:
<https://www.infectioncontroltoday.com/hand-hygiene/workplace-culture-impacts-hand-hygiene-
compliance>
9