University Report: Effectiveness of Nursing Hand Hygiene Interventions

This report examines the critical role of hand hygiene in nursing and its impact on infection control within healthcare settings. It emphasizes the significance of educational interventions for nursing professionals and healthcare workers in acute care units. The report employs the PICO framework (Population, Intervention, Comparison, Outcome) to assess the effectiveness of various evidence-based practices aimed at reducing hospital-acquired infections. The methodology includes a comprehensive literature search across databases like Google Scholar, PubMed, and CINAHL, using specific keywords and Boolean operators to select relevant, peer-reviewed articles published within the last 5-10 years. The articles are evaluated using the CASP (Critical Appraisal Skills Programme) tool. The findings synthesize evidence from multiple studies, highlighting the impact of training programs and interventions on improving hand hygiene compliance. The report concludes by recommending the adoption of educational interventions and assessment tools to enhance hand hygiene practices and reduce the risk of healthcare-associated infections.

Running head: Nursing and healthcare service
Nursing and Hand Hygiene Practice
Name of the Student
Name of the University
Authors Note
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1Nursing and Hand Hygiene Practice
Introduction
Transmission of infection is widespread in the hospital atmosphere, and healthcare-
associated disease can spread for lack of hand hygiene. Hand hygiene is essential for
reducing the tendency of infection transmission among patients and healthcare workers.
Different kind of strategies can be implemented for the betterment of health conditions of the
patients admitted to hospitals for a long time. Hand Hygiene Australia delivers resources and
necessary facilities for improving healthcare atmosphere and educational support related to
the training of nurses (Kwok, Juergens & McLaws 2016). World Health Organisation is
collaborated with different medical aid programs to ensure hand hygiene of healthcare
workers. Various techniques are used for practising hand washing of medical workers and
patients in the hospitals. The most popular hand washing technique popular among the patient
is “5 moment for hand hygiene” which is introduced by WHO (Moghnieh et al. 2017). There
are different hand hygiene media such as regular soap and water, alcohol-based hand
sanitisers and medicated hand hygiene antiseptics. These different medium come under
several levels of hand hygiene. Various training methods are essential for increasing hand
hygiene compliance among nursing professionals and patients admitted to hospitals for a long
time (Hoffmann et al. 2019). The assignment focuses on the significance of educational
interventions among nursing professionals and healthcare workers for improving infection
control in hospitals.
The assignment focuses on reviewing and synthesising the evidence of hand hygiene
practice from different studies, which are based on the effectiveness of the various
educational intervention on nursing professionals.
Well-designed clinical questions are formed to identify the critical aspects of the
clinical conditions from different evidence-based practices. PICO question framework is one
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of the most effective ways to analyse the problem of certain clinical practices. This
assignment takes the help of the PICO framework to analyse the effectiveness of different
evidence-based practice related to hand hygiene improvement. This framework generally
helps to make or propose some relevant questions, which influence the literature of evidence,
based practice of healthcare centres (Speckman & Friedly 2019). PICO stands for Population,
Interventions, Comparison, and Outcome. The question formed from this framework is to
assess the improvements in specific sectors and predict the possibilities related to that sector
and covered population.
The question guiding this evidence review is “In the acute care unit of a healthcare
sector, nursing education interventions are more effective in decreasing Hospital Acquired
Infections among the patients?”
The elements of this PICO question are;
P (Population) – Nurses and healthcare workers
I (interventions) – Different nursing education interventions related to hand hygiene
C (Comparison) – No training or education interventions
O (Outcome) – Reduction of the amount of contamination amongst the patients admitted to
the hospitals
Evidence search strategy
The articles have been obtained from Google Scholar, PubMed, CINAHL etc. Only
academic articles are selected for the assignment.
Keywords such as “hand hygiene”, “nurses “healthcare workers’’, “health care
sectors”, “training”, “education”, “interventions” etc. Different searching strategies, such as
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3Nursing and Hand Hygiene Practice
using Boolean operators and searching criteria, are used for selection of the articles from
different electronic databases. “AND”, “OR”, “+” are used as Boolean operators in searching
strategy.
There are some inclusion and exclusion criteria are selected for the selection of the articles.
The inclusion criteria for selecting articles from different databases are;
 Every article chosen for the assignment should be peer-reviewed and scholarly.
 The keywords should be included in the selected articles.
 The articles should be published within 5 to 10 years.
 Only the articles written in English are selected for the assignment
The exclusion criteria for selecting articles from different databases are;
 The articles, which are written in different languages instead of English.
 Articles, which are, not peer-reviewed and scholarly.
 The articles without specific keywords.
 Articles, which are not published within 5-10 years.
For evaluating the articles of these assignments, CASP (Critical Appraisal Skills
Programme) is used as the critical appraisal tool. The assessment tool can evaluate validity,
relevance, reliability and methods of different healthcare-associated groups (Buccheri &
Sharifi 2017). Critique tools aim to analyse and assess the research objectives for the
researches. The critical appraisal tool is used for evolving the sense of investigation and
assistances related to the studies (Rojas, Munoz-Gama, Sepúlveda & Capurro, 2016).
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4Nursing and Hand Hygiene Practice
Reviewing and synthesising the evidence
Name of the
article
Name of
Authors
Year of
publication
Type of
research
Relevance with
the PICO
question
Implementing
Guidelines to
Improve Hand
Hygiene
Compliance.
Currie, D. M. 2019 Systematic
analysis and
cross-sectional
analysis.
Qualitative
research
Evidence
supports the low
rates of hand
hygiene
compliances
among the
health care
workers of a
particular
hospital
Healthcare-
associated
respiratory
infections in the
intensive care
unit can be
reduced by a
hand hygiene
Finco, G.,
Musu, M.,
Landoni, G.,
Campagna, M.,
Lai, A., Cabrini,
L., ... &
Galletta, M.
2018 Quantitative
analysis
The result of
this study shows
that the majority
of the nursing
workers were
trained with
formal training,
and maximum
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program: A
multicenter
study.
workers showed
affinity to the
alcohol-based
hand sanitisers.
Investigating
the effect of
preparation for
and
participation in
a hand-
sanitizing relay
on nursing
students' ability
to recall the
WHO 6-step
hand hygiene
technique
Price, L.,
Melone, L.,
Cutajar, E.,
Blane, L.,
Gozdzielewska,
L., Young,
M., ... & Reilly,
J.
2018 cross-sectional
and
observational
survey
All the nurses
who work on
day shifts of the
participating
wards were
included in the
study. Control
group, which
comprised 27
nurses from the
surgical ward
and a general
medicine ward.
Hand hygiene
practices among
nursing
students: the
importance of
improving
current training
programs.
Mahmood, S.
E., Verma, R.,
& Khan, M. B.
2017 systematic
review
The active hand
hygiene
compliances are
some of the
most prevalent
factors for
enhancing
infection
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6Nursing and Hand Hygiene Practice
control in ICU
units
Hand hygiene:
nurses’
adherence after
training.
Graveto, J. M.
G. D. N.,
Rebola, R. I. F.,
Fernandes, E.
A., & Costa, P.
J. D. S.
2018 Systematic
Reviews and
Meta-Analyses
The
implementation
of the training
program and the
effectiveness of
the hygiene
programs have
been discussed
in the literature
review.
The article focuses on pre and post-education of “5 moments of hand hygiene” by
Sure wash kiosk among the nursing professionals. Evidence supports the low rates of hand
hygiene compliances among the health care workers of a particular hospital. Total of 266
participants was selected for the research (Currie 2019). The pre-education program is used to
collect data related to low compliances with hand hygiene and post education data collection
from the nurses determined the effectiveness of the hand hygiene compliances. The outcome
of this study is important as it delivers evidence-supporting point of care instruction to
recover hand hygiene compliance. Post education data presented a significant development of
compliance with the 5 Moments and methods defined during learning.
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7Nursing and Hand Hygiene Practice
The study focuses on the effectiveness of alcohol-based hand sanitisers in 12 months
expansion and the study included cross-sectional and observational surveys (Price et al.,
2018). No significant differences were found among the participants and non-performer of
the compliance. Total 170 participants were involved in the study and after dropouts, 163
participants were involved. The data collectors were trained in improving the reliability of
the study. The validity of this study was also improved, but the participants were blinded. The
outcome of the study states that the skill will decay after training was provided to the nurses
in enhancing the practice of hand hygiene in a better way. Feedbacks might be helpful for
improving the ability to recall all the steps related to the 6-step technique of hand washing.
The cross-sectional study was performed in nursing students among a college and
hospitals in India. A questionnaire was used for the self-administration of hand hygiene
practices (Mahmood, Verma & Khan 2017). The knowledge of nursing professionals was
checked with the help of 25 questions of the survey. The questionnaires was consisted of
multiple-choice answers with yes and no. The result of this study shows that the majority of
the nursing workers were trained with formal training, and maximum workers showed
affinity to the alcohol-based hand sanitisers. The knowledge of improving hand washing
compliances and practices to reduce healthcare-related infections.
This study is based on the literature review of different articles with the PICO
framework. The literature review is associated with the Cochrane methodology for better
outcome of the study (Graveto, Rebola, Fernandes & Costa, 2018). This literature review
involves a concept related to adherence and training of nurses. This literature review will
analyse the limitations of nurses such as lack of time, skin irritation, high workload, shortage
of nursing professionals and most importantly, lack of experience and training of nursing
staff (Finco et al, 2018). The studies show that adherence to hand hygiene will be increased
from 42.9% to 61.4% or from 63% to 76% after the specific training intervention. The
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8Nursing and Hand Hygiene Practice
implementation of the training program and the effectiveness of the hygiene programs have
been discussed in the literature review.
Recommendation of practice
The educational interventions are useful for increasing the habit of hand hygiene
among nursing professionals (Baria, Patel & Nayak 2018). There are several hygiene
assessment tools, which should be used during the evaluation of infection control in a
healthcare organisation. The assessment tools are used in improving of the hand hygiene in
the HAI in critical care unit (Or, Ching & Chung 2019). Promotion of different practices
regarding hand washing should be taken into consideration.
Conclusion
World Health Organisation is collaborated with different medical aid programs to
ensure hand hygiene of healthcare workers. Hand Hygiene Australia delivers resources and
necessary facilities for improving healthcare atmosphere and educational support related to
the training of nurses. The assignment focuses on reviewing and synthesising the evidence of
hand hygiene practice from different studies, which are based on the effectiveness of the
different educational intervention on nursing professionals.
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9Nursing and Hand Hygiene Practice
References
Baria, H., Patel, R., & Nayak, S. (2018). A Study on Knowledge and Practices Regarding
Hand Hygiene and Factors Affecting its Adherence among Healthcare Providers of a
Tertiary Care Hospital of South Gujarat. Healthline, Journal of Indian Association of
Preventive and Social Medicine, 9(2), 27-33. Retrieved from
http://www.iapsmgc.org/index_pdf/265.pdf
Buccheri, R. K., & Sharifi, C. (2017). Critical Appraisal Tools and Reporting Guidelines for
Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing, 14(6), 463-472.
doi.org/10.1111/wvn.12258
Currie, D. M. (2019). Implementing Guidelines to Improve Hand Hygiene Compliance.
Retrieved from https://scholarworks.waldenu.edu/dissertations/6548/
Finco, G., Musu, M., Landoni, G., Campagna, M., Lai, A., Cabrini, L., ... & Galletta, M.
(2018). Healthcare-associated respiratory infections in intensive care unit can be
reduced by a hand hygiene program: A multicenter study. Australian Critical
Care, 31(6), 340-346. doi.org/10.1016/j.aucc.2017.10.004
Graveto, J. M. G. D. N., Rebola, R. I. F., Fernandes, E. A., & Costa, P. J. D. S. (2018). Hand
hygiene: nurses’ adherence after training. Revista brasileira de enfermagem, 71(3),
1189-1193. doi.org/10.1590/0034-7167-2017-0239
Hoffmann, M., Sendlhofer, G., Pregartner, G., Gombotz, V., Tax, C., Zierler, R., & Brunner,
G. (2019). Interventions to increase hand hygiene compliance in a tertiary university
hospital over a period of 5 years: An iterative process of information, training and
feedback. Journal of Clinical Nursing, 28(5-6), 912-919. doi.org/10.1111/jocn.14703
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Kwok, Y. L. A., Juergens, C. P., & McLaws, M. L. (2016). Automated hand hygiene auditing
with and without an intervention. American journal of infection control, 44(12), 1475-
1480. doi.org/10.1016/j.ajic.2016.08.014
Moghnieh, R., Soboh, R., Abdallah, D., El-Helou, M., Al Hassan, S., Ajjour, L., ... &
Mugharbil, A. (2017). Health care workers' compliance to the My 5 Moments for
Hand Hygiene: Comparison of 2 interventional methods. American journal of
infection control, 45(1), 89-91. doi.org/10.1016/j.ajic.2016.08.012
Or, P. P., Ching, P. T., & Chung, J. W. (2019). A program to improve the hand hygiene
compliance of Hong Kong preschoolers with an insight into their
absenteeism. American journal of infection control, 47(5), 498-503.
doi.org/10.1016/j.ajic.2018.11.014
Price, L., Melone, L., Cutajar, E., Blane, L., Gozdzielewska, L., Young, M., ... & Reilly, J.
(2018). Investigating the effect of preparation for and participation in a hand-
sanitizing relay on nursing students' ability to recall the WHO 6-step hand hygiene
technique. American journal of infection control, 46(11), 1304-1306.
doi.org/10.1016/j.ajic.2018.04.222
Rojas, E., Munoz-Gama, J., Sepúlveda, M., & Capurro, D. (2016). Process mining in
healthcare: A literature review. Journal of biomedical informatics, 61, 224-236.
doi.org/10.1016/j.jbi.2016.04.007
Speckman, R. A., & Friedly, J. L. (2019). Asking Structured, Answerable Clinical Questions
Using the Population, Intervention/Comparator, Outcome (PICO)
Framework. Pm&r, 11(5), 548-553. doi.org/10.1002/pmrj.12116
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