Hand hygiene on emergency medical services PDF

Running Head: HAND HYGIENE ON EMERGENCY MEDICAL SERVICES 1
HAND HYGIENE ON EMERGENCY MEDICAL SERVICES, LITERATURE REVIEW
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HAND HYGIENE ON EMERGENCY MEDICAL SERVICES 2
Hand Hygiene on Emergency Medical Services, Literature Review
Hand Hygiene Training and Improvement practices in Emergency Medical Service have
always been crucial for healthcare workers. This is because of their positive impacts like
mitigating risks of infecting workers, patients, and family members. While handwashing is rarely
taken as a big deal, healthcare workers should realize that this is the foundation for many
healthcare infections under control programmes. Studies have indicated that emergency medical
technicians, paramedics, and other healthcare professionals have got a bad reputation because of
their poor hand hygiene practices like failure to wash their hands after attending to patients.
Infections such as influenza, meningitis and the common cold have increased in hospital settings
as a result of unhygienic Advanced Life Support (ALS) ambulances. In 2015, research on hand
washing practices among the emergency medical service providers indicated that pre-hospital
service providers such as emergency medical technician had poor hand hygiene (Benjamin,
Hargrave & Nether, 2016). Also, the researchers emphasized the need for intervention to
improve Emergency Medical Services (EMS) hand hygiene. This paper reviews some of the
past research studies on Emergency Medical Services (EMS) hand hygiene.
According to World Health Organization (WHO), hospital-associated diseases and
infections (HIAs) affect many patients annually, a trend which has been closely linked to non-
compliance with hand hygiene by the clinical staff and other healthcare workers (Prabhakumar et
al, 2016). Infection control measures like poor hand hygiene have also been attributed to the
spread of diseases and infections (Benjamin, Hargrave & Nether, 2016). Since strict monitoring
of Emergency medical service (EMS) practitioners has not been implemented in many hospitals’
to enhance hand hygiene training and compliance, hospital facilities have remained unfavorable
when compared to the traditional based aseptic techniques.

HAND HYGIENE ON EMERGENCY MEDICAL SERVICES 3
Health care workers have described hygiene as the single most important tool in
controlling the spread of some of the healthcare-associated infections (HAIs) like catheter-
associated urinary tract infection and central line-associated bloodstream infection (Teter, Millin
& Bissell, 2015). Comparison report on patient-care activities by the WHO indicated that
patient-care activities like dressing wounds which have the likelihood of transmitting infections
to health care workers were very few (dressing and undressing wounds) compared to those of
healthcare workers transmitting to patients. Although bacteria are most likely to be found on
health care workers after being involved in activities such as respiratory tract care, wound care,
handling patient secretions, and intravascular catheter care, other health care workers (HCW)
activities which were linked with bacteria included direct contact with the patients when taking
measurements like temperature, pulse, and blood pressure (Teter, Millin & Bissell, 2015).
The study has also identified the most common organisms transmitted from HCW hands
to patients, Clostridium difficile, Staphylococcus aureus Klebsiella spp and MRS. Kwok, Callard
& McLaws (2015) added that HCW hands could be contaminated through various ways other
than coming into direct contact with the patients. Also, it revealed that HCW direct contact with
contaminated services within the patient environments as well as touching contaminated charts at
the nurse station could also lead to the acquisition of infectious pathogens. This research,
therefore, emphasized washing hands before and after dealing with the patients as the only safest
approach to avoid the spread of bacteria and other disease-causing organisms between patients.
According to research by Wilson (2017), one out of twenty-five patients acquired
healthcare-associated infections (HAIs) in the course of their stay at the hospital, approximately
722, 000 infections per year. The research revealed that this problem was common even to the
most advanced health care units and could only be regulated by enforcing strict policies on hand

HAND HYGIENE ON EMERGENCY MEDICAL SERVICES 4
hygiene. Similar to other study findings, this study has also tackled hand hygiene extensively and
revealed the challenges involved in its implementation. It stipulates that the concept of hand
hygiene was introduced in the 1800s by a Hungarian physician known as Ignaz Semmelweis in
his suggestion on physicians to be washing their hands before delivering babies to prevent the
death of women in postpartum. His suggestion was highly ridiculed but eventually recognized as
the best approach. Following the observations of Semmelweis, this study went ahead to confirm
the crucial role played by hand hygiene in preventing the transmission of pathogens in any health
care setting. This study outlined five moments in which hand hygiene should be maintained
which included: before getting into contact with a patient; before any aseptic task; after being in
contact with a patient; after bodily fluid exposure and finally after getting into contact with the
patient surroundings.
Despite these guidelines and different commission having been set aside to monitor the
quality assessment protocols set for hand hygiene practices in hospital, the rates of compliance to
the set guidelines such as washing hands after attending patients in wards have remained low
than they are expected. This study indicated that the adherence to hand hygiene ranged as low as
50% to 60%, a trend which was seen to require a long and sustained effort accompanied by
multifaceted interventions in order to change.
To add on the findings above, Nabavi et al (2015) in their research indicated that
diarrhea is responsible for 25-40% of children deaths reported after emergencies. Ensuring
appropriate handwashing with soap and water in crisis settings can likewise secure the
advancement made before a crisis. Handwashing foundation and conduct programmes in crises
regularly require distinctive methodologies contrasted with non-crisis settings (Ariyaratne et al,