Hand Hygiene Issues

This document discusses the importance of hand hygiene in healthcare settings and the consequences of improper hand hygiene practices. It highlights a personal experience of a nursing student and provides insights into the causes and prevention of healthcare-associated infections. The document also includes an action plan for improving hand hygiene skills and knowledge.

Running head: HAND HYGIENE ISSUES
HAND HYGIENE ISSUES
Name of the student:
Name of the university:
Author note:

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HAND HYGIENE ISSUES
Description:
During the time of placement in the respiratory ward, I once had to care for an old patient
with multi-morbid disorders. He was primarily admitted to the ward because he faced shortness
of breath the previous night and was immediately admitted to the respiratory ward. He was
diagnosed with chronic obstructive pulmonary disorders and his excessive levels of smoking
were stated to be the main contributor for the disorder. Besides, he was suffering from diabetes
and had many wounds all over the skin due to poor skin integrity. He had unmanaged diabetes
with high levels of blood glucose. The wounds were not dressed properly and therefore, nursing
professionals needed to dress his wounds properly. During one of the busy days, I was given the
responsibility of dressing the wounds by the senior facilitator. It was a very busy shift and I had
to handle many patients within a short span of time. Therefore, I was rushing from one patient to
another completing their assessments of health, meeting their needs, documenting important
information and many others. I was supposed to administer a medication to one patient and dress
the wounds of the quoted patient at the same time. Therefore, I could not set the priorities right
and chose the dressing intervention as the first task to proceed with it. As I was in a hurry, I
could not get time for washing my hands and using sanitizers. I also did not wear gloves out of
hurry and immediately started dressing the wounds. After completing the task, I went to the next
patient for administration of the medication. Later, my mentor called me in the ward, where she
stated that the quoted patient had developed infections of MRSA and his sufferings had
increased. She was upset about my carelessness and asked me to be careful from the next time. I
visited the patient seeing that the infected areas on the skin had become red and swollen and the
person was suffering from intense pain.

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Feelings:
Immediately after witnessing the entire incident, I felt embarrassed, as I could not fulfill
the responsibility and oath of a nursing professional to provide safe and quality care to a patient.
I felt terribly upset with my own performance, as I could not do justice to the expectation of the
nation from a responsible nursing professional. I felt quite sad that I could not step up the
expectation of my facilitator who had so much trust and confidence on my knowledge. I was
quite disheartened by seeing the suffering of the patient which had increased due to my improper
hand hygiene. I realized that it was because of my improper following of hand hygiene protocols
that had made the patient infected with MRSA (methylene-resistant staphylococcus aureus).
However, I also felt that this failure in effective treatment helped me realize that I do not have
proper skills for effective maintenance of hand hygiene and therefore. Therefore, I promised
myself to become more knowledgeable and develop expert skills that would help me to maintain
hand hygiene effectively and reduce chances of spread of infection successfully.
Evaluation:
The bad part of the experience was that it resulted in huge suffering for the patient.
Nursing philosophies as well as bioethical principles advice nurses to follow the two important
ethics of beneficence and non-maleficence (Shinde and Mohite 2014)). Beneficence dictates
nurses to provide care to patients which are not only safest but also evidence based and would
bring out the best outcomes in the patient helping in their comprehensive and holistic recovery
(Smidy et al. 2015)). Non-maleficence on the other hand dictates healthcare professionals to
apply interventions in ways that should not cause any form of suffering or negative impacts on
the health of the patients. However, I had failed to follow both the bioethical principles as my

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care had not only caused suffering of the patient but had also proved that I have also not
followed the hand hygiene protocols successfully. The good part of the incident was that it taught
me that I do not have proper time management skills to manage more patients successfully
within a limited amount of time. I often tend to get nervous and take wrong decisions out of
nervousness. Moreover, this incident also helped me to realize that I do not have proper
knowledge about hand hygiene and therefore could not follow the protocols. Helping me to
identify my knowledge gaps is the only food part of the incident.
Analysis:
After analyzing through the different segments of the incident that day and later
discussing the entire incident with my mentor, I had developed huge amount of knowledge. I
also had conducted evidence-based research after the incident to develop good ideas about how
the entire incident had resulted and what caused the increase in severity of the patient’s
condition. Bacteria alone are the contributors of 90% of the cases of the hospital-acquired
infection while fungus and viruses result in the rest of the 10% of the cases (Luangasanatip et al.
2015). Some of the common types of bacteria that can be responsible for the development of
such form of infections are staphylococcus aureus, Escherichia coli, Enterococci as well as
Pseudomonas Aeruginosa (Castle et al. 2016). This form of microbes might spread
predominantly through different person-to-person contact and this can include unclean hands as
well as handling of contaminated medical instruments and other hospital equipments. Studies are
of the opinion that MRSA might spread through contaminated equipments as well as through
contacts of contaminated objects (Hou et al. 2017). Researchers are of the opinion that nurses
always do not need to touch directly a patient for the spreading of the infection. Even touching,
hospital beds, rails, doorknobs and many others, which were contaminated, can spread such

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infections. Cross contamination occurs through particular steps. Firstly, organisms remain
present either in skin or on inanimate objects. Organisms are then transferred to the hands of the
healthcare workers. The organisms are then seen to survive on the skin for several minutes.
Inadequate or that of absent hand hygiene might cause the organism to spread. Direct contact
with a patient might enable successful transmission of the microbes (Gould et al. 2017).
It has been seen in the articles that simply washing the hands or that of rubbing the
alcohol immediately after coming in contact with the organisms can prevent their ability in
surviving on the skin (Foote et al. 2016). It is important for the healthcare professionals to know
how to maintain hand hygiene and wash our hands prior to manage wound dressing interventions
or contacts with patients. Hand Hygiene WHO has successfully identified 5 crucial timings when
hand hygiene protocols need to be followed (Cruz et al. 2016). These are before touching a
patient, before a procedure, after a procedure or body fluid exposure, after touching a patient as
well as after touching the surrounding of a patient. The WHO guidelines for hand washing
mainly advise healthcare professionals to follow certain basic steps for maintaining hand
hygiene. At first, the healthcare professionals should wet hands with water and thereby apply
enough soap for covering all the hand surfaces. Then they should rub palm to palm, then right
palm over left dorsum with the fingers in interlaced position (Kingston et al. 2017). Then the
washing motion should follow the palm-to-palm movement with fingers interlaced followed by
back of fingers to opposing of the palms with fingers interlocked. Rotational rubbing of the
palms followed by rinsing of hands, drying thoroughly are some of the steps that are needed to
be followed (Doronina et al. 2017). Using gloves, sanitizing the hands, sterilizing equipments
and similar other actions are important to prevent spread of disorders.

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Conclusion:
From the above discussion, it has been clearly seen that maintenance of hand hygiene
protocols is extremely important for spreading of different types of healthcare associated
infections. Failure of this can result the patient to be infected with harmful microorganisms that
can not only affect the conditions of their wounds but also add to the sufferings of the already
present disorders (Karadag et al. 2016). Such incidents might increase the length of hospital stays
of the patients, readmissions, excessive preventable sufferings, huge expenditure of healthcare
resources, financial drainage of patients and many others (Chassin et al. 2015). Therefore, I need
to be extremely cautious while handling patients and ensure following of hand hygiene protocols
strictly.
Action plan:
The first skill and knowledge that I need to develop is the hand hygiene maintenance
skills and protocols. I would mainly do these by searching various nursing and healthcare
databases and thereby find out peer-reviewed articles that give me more insight into the topic.
Moreover, I would also join workshop sessions that would mainly help in developing the
practical skills of maintaining hand hygiene and would make me expert in this aspect. Moreover,
I also have self-awareness and self-regulation issues and cannot control my nervousness and
emotions successfully. Therefore, I would try to engage in mindfulness-based therapies as well
as yoga and meditation. All these initiatives would help me in regulating myself successfully and
help me in managing myself in strenuous situations successfully. These would help me become
an experts nursing professional and provide best care to my patients ensuring patient satisfaction.

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References:
Castle, N., Handler, S. and Wagner, L., 2016. Hand hygiene practices reported by nurse aides
in nursing homes. Journal of Applied Gerontology, 35(3), pp.267-285.
Chassin, M.R., Nether, K., Mayer, C. and Dickerson, M.F., 2015. Beyond the collaborative:
spreading effective improvement in hand hygiene compliance. The Joint Commission Journal on
Quality and Patient Safety, 41(1), pp.13-AP3.
Cruz, J.P. and Bashtawi, M.A., 2016. Predictors of hand hygiene practice among Saudi nursing
students: A cross-sectional self-reported study. Journal of infection and public health, 9(4),
pp.485-493.
Doronina, O., Jones, D., Martello, M., Biron, A. and Lavoie‐Tremblay, M., 2017. A systematic
review on the effectiveness of interventions to improve hand hygiene compliance of nurses in the
hospital setting. Journal of Nursing Scholarship, 49(2), pp.143-152.
Foote, A. and El-Masri, M., 2016. Self-perceived hand hygiene practices among undergraduate
nursing students. Journal of Research in Nursing, 21(1), pp.8-19.
Gould, D.J., Moralejo, D., Drey, N., Chudleigh, J.H. and Taljaard, M., 2017. Interventions to
improve hand hygiene compliance in patient care. Cochrane database of systematic reviews, (9).
Hou, C., Rosenberg, M., Steer, R., Miller, M., Cricco, C. and Campos, K., 2017. How to Increase
Hand Hygiene Adherence for Nurses with an Electronic Warning System. American Journal of
Infection Control, 45(6), p.S59.

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Karadag, M., Pekin Iseri, O., Yildirim, N. and Etikan, I., 2016. Knowledge, beliefs and practices
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Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A.S., Harbarth, S.,
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