Systematic Review on Hand Hygiene: Importance and Compliance

A systematic review on hand hygiene from scholarly
databases
ABSTRACT
BACKGROUND
Maintenance of hand hygiene not only reduces the probability of a patient to develop
an infection but also reduces the probability for the care providers to develop an
infection. On the basis of the PICO format the following questions can be deduced to
understand the background of the situation.
• Population: Does the maintenance of hygienic environment affect the ability of
the nursing professionals to provide care to the patients?
• Intervention: Does effective method of hand hygiene help in the control of
infections?
• Comparison: Is the method an effective germ control strategy?
• Outcome: Does hand hygiene effectively help in the reduction of infections?
OBJECTIVES
• A systematic literature review was conducted in order to understand the
importance of maintaining hand hygiene for patient safety. The objectives were
listed as the following:
• To identify a proper strategy to reduce the prevalence of infections within the
hospital setting
• To elucidate the challenges with respect to stringent hand hygiene compliance
practices
• To identify the events when hand hygiene should be performed on a mandatory
basis
METHODS
• In order to conduct the systematic review, a thorough search was carried out on
research databases such as Medline and PubMed. The search was conducted on
the basis of the inclusion and exclusion criteria. While the inclusion criteria
included a thorough search on papers published in the English language and
between the time period of 2013-2017, the exclusion criteria omitted papers that
were published in other languages and prior to 2013. In order to critically
appraise the research studies the JBI appraisal tool was used.
DISCUSSION
• 80% infectious diseases are transmitted through touch (Allegranzi et al. 2013)
• Comparing the global health scenario, 50% of the health care organizations fail to comply with
the WHO hand-hygiene guidelines (Jackson et al.2015)
• Lack of awareness among health care professionals about the importance of maintaining hand
hygiene has been reported to be a primary cause for the transmission of infections however
awareness and training by supervisors have yielded positive outcome (Seibert et al. 2014)
• More than 50% of the professionals do not know the correct routine of hand washing
technique (Smiddy et al. 2015)
• Maintenance of proper hand hygiene can help in the reduction of infection rate within the
hospital setting up to 60% (Smiddy et al. 2015)
RESULTS
Category 1 Category 2 Category 3 Category 4
0
1
2
3
4
5
6
Series 1; 4.5
Series 2; 2.8
Series 3; 5
Chart Title
Axis Title
Category 1 Category 2 Category 3 Category 4
0
1
2
3
4
5
6
Series 1; 4.5
Series 2; 2.8
Series 3; 5
Chart Title
Axis Title
CONCLUSIONS
• Hence, it can be concluded that the healthcare associated infections can be
controlled to a considerable extent with effective training programs to
educate about hand hygiene
• Health care organizations must ensure on a mandatory basis that
professionals comply with the hand hygiene guidelines.
• It has been reported that most of the infectious diseases are transmitted from one
individual to another through contact. Maintenance of proper hand hygiene can
help in the prevention of infections to a great extent. It should be noted here that
care providers engaged in the process of delivering care often overlook the
importance of maintaining hand hygiene and as a result it leads to the
manifestation of infections. On an average 1 out of every 25 patients are affected
with microbial infection due to the negligence of the health care professionals.
Through this systematic review we aimed to evaluate the level of hand hygiene
standards followed by professionals across different health care organizations.
• The major reasons that have been identified in health care professionals as obstacles to maintain hand hygiene
includes, carrying or lifting something, use of gloves, using a cell phone and managing the workstation (Smiddy et
al. 2015)
• Further it has also been mentioned that professionals must wash their hands thoroughly prior to touching a
patient, before and after the antiseptic procedure, after exposure to body fluid, after touching a patient and the
surroundings on a mandatory basis and awareness can help in complying with the WHO standard (Allegranzi et
al.2013)
PRISMA 2009 Flow Diagram
PRISMA 2009 Flow Diagram
Records identified through database
searching
(n = 10 )
Additional records
identified through other
sources
(n = 2 )
Records after duplicates removed
(n =4 )
Records screened
(n =8 )
Records excluded
(n = 2)
Full-text articles assessed for
eligibility
(n =6 )
Full-text articles excluded,
(do not meet inclusion)
(n = 1 )
Studies included
in literature
review
(n = 5 )
PRISMA 2009 Flow Diagram
REFERENCES
Allegranzi, B., Gayet-Ageron, A., Damani, N., Bengaly, L., McLaws, M. L., Moro, M. L., ... and Donaldson, L. 2013. Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. The Lancet
infectious diseases, 13(10), 843-851.
Jackson, C., Lowton, K., and Griffiths, P. 2014. Infection prevention as “a show”: A qualitative study of nurses’ infection prevention behaviours. International journal of nursing studies, 51(3), 400-408.
Seibert, D. J., Speroni, K. G., Oh, K. M., DeVoe, M. C., and Jacobsen, K. H. 2014. Preventing transmission of MRSA: a qualitative study of health care workers’ attitudes and suggestions. American journal of infection control, 42(4), 405-411.
Smiddy, M. P., O'Connell, R. and Creedon, S., A. 2015. Systematic qualitative literature review of health care workers' compliance with hand hygiene guidelines. American journal of infection control, 43(3), 269-274.