Evidence-Based Nursing 1: Hand Hygiene's Role in Infection Control

This report, focusing on Evidence-Based Nursing (EBN), investigates the impact of hand hygiene on reducing hospital-acquired infections (HAIs). It begins with an introduction highlighting the growing rate of HAIs and the importance of hand hygiene as a preventive measure. The report justifies the application of the EBP process, outlines the answerable question using PICO elements, and details the search strategy protocol. The core of the report is a literature search, which synthesizes findings from various studies, emphasizing the significance of hand hygiene in controlling and managing HAIs. The literature review covers key aspects of hand hygiene, including the use of CHG (chlorhexidine gluconate), the role of education and resources, and the impact on HAI rates. The report concludes that hand hygiene is a crucial intervention for reducing the risk of HAIs and provides a comprehensive overview of the topic, supporting the importance of hand hygiene in healthcare settings.

EVIDENCE BASED NURSING 0
What is the effect of using
correct hand hygiene
procedures to reduce the risk of
hospital-acquired infections in
patients

EVIDENCE BASED NURSING 1
Table of Contents
Introduction....................................................................................................................................2
Justification of Application of EBP Process..................................................................................2
Answerable Question Breakdown................................................................................................2
PICO Elements............................................................................................................................2
Search Strategy Protocol...............................................................................................................2
Literature search or Search Results.............................................................................................2
Conclusion......................................................................................................................................4
References......................................................................................................................................6

EVIDENCE BASED NURSING 2
Introduction
Hand hygiene is an effective approach for preventing hospital-acquired infections in
patients. The rate of hospital-acquired infection is growing rapidly which directly impact
on patient care (Abdella, et al., 2014). The goal of this investigation is to analyze the
significance of hand hygiene in the reduction of hospital-acquired infections in patients. In
this investigation, a literature search will be included for a better understanding of the
viewpoints of other experts and also highlight the findings and outcomes of previous
investigations.
Justification of Application of EBP Process
It is very important for nurses to understand and analyze the importance of hand
hygiene process in the reduction of hospital acquired infections by which the nurses can
provide better services to the patients.
Answerable Question Breakdown
PICO Elements
P- Risk of hospital acquired infections
I- Hand hygiene procedures
C- Complying with hand hygiene process and no hand hygiene process
O- Reduction of hospital acquired infections
Search Strategy Protocol
Google scholar is the best database for finding journal articles related to the
research topic and in this investigation, Google scholar and ProQuest both databases are
used. In which the topic of the research is searched in the selected database and
categorized in the peer-reviewed and journal articles.

EVIDENCE BASED NURSING 3
Literature search or Search Results
The purpose of this literature search is to examine the key aspects of hand hygiene
and their significance in the reduction of hospital-acquired infections and issues. There are
numbers of papers were published on this topic in the last five years where the authors
critically reviewed the concept behind the hand hygiene process.
Chassin, Mayer, & Nether, (2015) argued that around 2.5 million acquired contagions
happen per years in the worldwide and more than 56% of individuals are suffering from
the HAI problem. It is very significant for health care providers to identify the risk factors
that increase the rate of hospital-acquired infections. The authors suggested that hand
hygiene is one of the effective processes for controlling and reducing the rate of HAI in
patients. More than 56% of health care systems are using the concept behind hand hygiene
approach for handling the risk of HAI in the patients. A recent survey identified that more
than 14 million individuals were suffered from the HAI problem in Australia between 2016
and 2017.
There are major two risk factors which increase the rate of HAI in the patients, for
example, lack of education and lack of proper resources (White, et al., 2015). In order to
control such kinds of issues, the key aspects of hand hygiene may be used because of their
ability to reduce the risk of HAI in the patients and provide better intervention programs to
the patients. According to Fox, et al., (2015) hand hygiene is an appropriate process which
can be included in the health care systems for controlling and managing the rate of HAI
infections. From this paper, it has found that lack of resources is a key issue in the health
care systems due to which the nurses are not able to implement a hand hygiene system in
the hospitals. In the hospitals, most of the patients do not use daily bathing with CHG due to
which numbers of infections and problems increase in the workplace which may be solved
by using a hand hygiene system. recent literature observed that the rate of HAI was
decreased by 23% in last two years because of the hand hygiene process where the nurses
provide the reliable and effective services to the patients and lead the patient safety in an
effective manner (Sharma, 2018).

EVIDENCE BASED NURSING 4
In the hand hygiene mainly CHG (chlorhexidine gluconate) is included because of
their ability to kills unwanted infections from the human body systems and provide a
platform where the patients can improve their health. Fuller, et al., (2014) argued on this
point and highlighted that using CHG along with the hand hygiene is a best approach in the
reduction of HAI infections where CHG provide continuous microbial killings for around 6
hours by disrupting the bacterial cells and unwanted infections.
Gould, Moralejo, Drey, Chudleigh, & Taljaard, (2017) suggested that nurses should
be promoted in the health care systems and provides complete information related to HAI
infections. The author also conducted a literature survey and identified that in the year
2017 the rate of HAI has decreased by 45% because of the hand hygiene process. There are
several risk factors linked with the hand hygiene due to which the nurses are not able to
reduce the rate of HAI, for example, blisters, dry cracked skin of the patients and so on
(Smiddy, O'Connell, & Creedon, 2015). It is observed that hand hygiene is the most
common process for reducing the issue of HAI in the patients which control and manage
the unwanted infections occurred in the human body and lead the patient safety effectively.
According to world health organization developing and implementing hand hygiene-
related strategies in the hospitals may reduce the risk factors of HAI in the patients.
Kingston, O'Connell, & Dunne, (2016) suggested five moments for hand hygiene for
reducing the problem of HAI including before touching a patient, before cleaning process,
after touching a patient and after touching the surrounded parts of a patient. All these
kinds of moments are able to protect the human body system from the harmful germs and
unwanted infections occurred in the patients.
Luangasanatip, et al., (2015) observed that hand hygiene is an appropriate
intervention in the reduction of HAI infections from the patients. As compared with other
studies, this paper provided in-depth analysis about the hand hygiene along with the HAI
and also highlighted the impacts of hand hygiene on the HAI problem. Therefore, it is stated
that most of the authors provided positive aspects of hand hygiene and evaluated their
significance in the reduction of HCI.

EVIDENCE BASED NURSING 5
Conclusion
It is concluded that hand hygiene is the best intervention program which can be used for
reducing the risk of hospital-acquired infections. This proposed study critically reviewed
and evaluated the role of hand hygiene in the HAI and also analyzed the viewpoints of other
researchers. From the above literature search, it is observed that most of the authors
concluded the same points towards hand hygiene and also highlighted the risk factors
which increase HCI in the patients.

EVIDENCE BASED NURSING 6
References
Abdella, N. M., Tefera, M. A., Eredie, A. E., Landers, T. F., Malefia, Y. D., & Alene, K. A. (2014).
Hand hygiene compliance and associated factors among health care providers in
Gondar University Hospital, Gondar, North West Ethiopia. BMC public health, 14(1),
96.
Chassin, M. R., Mayer, C., & Nether, K. (2015). Improving hand hygiene at eight hospitals in
the United States by targeting specific causes of noncompliance. The Joint
Commission Journal on Quality and Patient Safety, 41(1), 4-12.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., ... & Bader, M. K.
(2015). Use of a patient hand hygiene protocol to reduce hospital-acquired
infections and improve nurses' hand washing. American Journal of Critical Care,
24(3), 216-224.
Fuller, C., Besser, S., Savage, J., McAteer, J., Stone, S., & Michie, S. (2014). Application of a
theoretical framework for behaviour change to hospital workers' real-time
explanations for noncompliance with hand hygiene guidelines. American journal of
infection control, 42(2), 106-110.
Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions to
improve hand hygiene compliance with inpatient care. Cochrane database of
systematic reviews, (9).
Kingston, L., O'Connell, N. H., & Dunne, C. P. (2016). Hand hygiene-related clinical trials
reported since 2010: a systematic review. Journal of Hospital Infection, 92(4), 309-
320.
Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth,
S., ... & Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand
hygiene in hospital: a systematic review and network meta-analysis. BMJ, 351,
h3728.

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Sharma, S. (2018). Hand hygiene and hospital-acquired infections. Medical Journal of Dr DY
Patil Vidyapeeth, 11(3), 201.
Smiddy, M. P., O'Connell, R., & 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.
White, K. M., Jimmieson, N. L., Obst, P. L., Graves, N., Barnett, A., Cockshaw, W., ... & Martin, E.
(2015). Using a theory of planned behaviour framework to explore hand hygiene
beliefs at the ‘5 critical moments' among Australian hospital-based nurses. BMC
health services research, 15(1), 59.