Hand Hygiene: Analysis of Compliance in Healthcare Settings Report

This report examines the critical importance of hand hygiene in healthcare, particularly within intensive care units (ICUs). It analyzes two research articles focusing on hand hygiene compliance among healthcare workers and the impact of interventions designed to improve adherence to hand hygiene protocols. The report highlights the significance of alcohol-based hand rubs over traditional soap and water, the barriers to compliance (including knowledge gaps and organizational issues), and the role of training programs and readily available supplies. It also discusses the impact of non-compliance on nosocomial infections and the strategies for improving hand hygiene practices, such as the 'five moments' for hand hygiene and the implementation of multidisciplinary programs. The conclusion emphasizes the need for proactive measures, including monitoring, education, and readily accessible resources, to ensure better hand hygiene practices and reduce healthcare-associated infections.

Hand Hygiene September 10
2017

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Introduction
Hand hygiene (HH) is considered as the most significant factor in controlling or preventing
the transmission of the acquired infections in the hospitals, but the compliance related to the
hand hygiene is done at the very low pace in the hospitals. Both the research articles
discussed the health hygiene preventive measures and the interventions that are done for
increasing the compliance of health hygiene in the in the ICU (intensive care units) (Sadule-
Rios & Aguilera, 2017). The infections related to the Healthcare cause, a common threat to
the safety of the patients and also the significant burden of the disease. The single significant
measure of prevention form the disease in ICU is the hand hygiene (De Wandel, 2017). There
are certain barriers which had adherence with the recommendations related to the healthh and
Hygiene and include knowledge gaps, organisational issues, and the structural gaps. As per
the centres of Disease prevention and control and the guidelines of WHO related to the health
and hygiene in the ICU includes the hand rub alcohol based is to be preferably used as the
daily hand antiseptics. Alcohol contains the hand disinfection which is considered as an
effectual substitute to regular soap and water (De Wandel, 2017).
Summary:
The objective of the study is to measure the degree of the compliance related to the health
hygiene practices among the workers in health care units at the ACH and south-western Saudi
Arabia. The study concluded that there is a high range of the non compliance related to the
health hygiene among the workers working in the ICU units of the hospital (Mahfouz, et. al,
2013). The training programmes related to the health hygiene are to be performed at the
hospitals at the regular interval times. In the studies, it was found that the doctors are having
the high level of the noncompliance of hand hygiene among them and certain other studies

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concluded that only one third doctor believes that hand hygiene is vital to befoe coming in
contact or touching the patients for the treatments (Mahfouz, et. al, 2013). The pragmatic
high figures related to the non compliance of the hand hygiene warrant increasing education
to encourage local hand hygiene and instruction programs to assist embed effective and
efficient hand hygiene into the different elements of care delivery in the ICU of ACH. It is
advised to the health workers to follow the five moments for the Health Hygiene that is to
wash hands before touching the patients, secondly before applying the antiseptic process,
after an exposure risk to the body fluid, after touching the patient and finally after touching
the surroundings of the patients (Mahfouz, et. al, 2013).
Summary:
The second article researched certain infections such as the Nosocomialinfections (caused by
the fungal pathogens and viral bactrias) are the one of the major complication in the
intensive care unit (Hugonnet, et. al, 2002). Even though hand hygiene is the sole well-
organized preventive gauge, fulfilment with this straightforward action remnant low. Our
interference induced a noticeable and sustained augment in compliance with hand over
cleanliness. In concentrated care unit, a smaller amount of time-consuming hand rubbing may
put back standard hand washing and conquer the fence of time constraint (Hugonnet, et. al,
2002). Hands rubbing and that too properly is highly necessary and important so that it is
ensured that the required defensive measures are put up and there is nil chance of any kind of
infection at the time of the operation, the germs attack infected or injured bodies easily and
quickly (Hugonnet, et. al, 2002). The Hygienic atmosphere provides immediate recovery
from the infections and injuries and helps early wellness. Infected patients are on the verge of
becoming sicker if they are further prone to the infected area. The procedure of taking proper
hygienic precautions are very easy to follow thus it must be implemented in all the
circumstances.

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Critical analysis:
Both the articles studies focused on the non compliance of the hand hygiene among the helath
workers of the area. In the hand hygiene compliance which was held among the different
hospitals, it was observed that around 41 % of the health workers are non compliance under
the helath hygiene, around 36.2% of the workers are rubbing hands with the alcohol and
22.8% workers are doing the hand washing with soap or water. Hence through intervention,
the bottles of the alcholo based rub solution are made available to the staff and are
encouraged to make use of the solution during the workers hours and this made a great
increase in the usage and improved the compliance over the time. Both the articles focused on
the compliance and the results related to the interventions to improve the hand hygiene
compliance in the intensive care units (Hossein & Sajjad, 2009).
Both the artices critically analysed the strategies related to the hygiene with the team
approach, continuous evaluation, and health education results into an increased compliance,
but was not sustained in the certain different critical areas of care (such as before arterial
care, respiratory care, urinary or wound care). It is also believed that lack of the motivation
and the increased workload may result into the increased causes of the poor compliance
(Hossein & Sajjad, 2009). Hence the better accessibility related to the supplies of the health
hygiene and the proper training among the hospital staff is a perquisite to the sufficient
compliance. This create an awareness among the staff and the presence of the required
material in the intensive cares will help the staff in going through the compliance related to
the hand hygiene.
Articles analysed certain multidisciplinary programs that result in an increased utilization of
the alcoholic hand rub which in turn increases the conformity of healthcare workers with the
suggested hand hygiene practice and the condensed pervasiveness of nosocomial infections.

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Interventions related to the hand hygiene have to include the compliance control, which is
frequently conducted by the straight observation (Shukla et. al, 2014)
Conclusion:
Hand hygiene is predominantly significant in the supervision of decisively ill patients within
an ICU. Consequently, the practical approach for promoting the hand hygiene among the
intensive care unit include the situation of the smallest figure of a hand rub dispenser
according to the per bed, the inventory is to be available in the unit and the quantity of the
alcohol based rub consumption is used to monitor the compliance, and selection of the most
striking product. The lack of knowledge related to the guidelines of the hand hygiene, be
deficient in of recognition of opportunities related to hand hygiene during patient care, and in
lieu of awareness related to the risk of cross-transmission of pathogens are a barrier to the
better practices of the hand hygiene (Shukla et. al, 2014). Obedience to the recommendations
related to the hand hygiene is considered as a significant means to control and prevent the
spread of (HCAI) healthcare associated infections.

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References
De Wandel, D. (2017). Key factors for hand hygiene promotion in intensive care
units. Intensive And Critical Care Nursing, 5(10),99-100
Hossein, S., & Sajjad, R. (2009). Hand washing versus hand hygiene in intensive care unit: A
clinical trial. Journal Of Critical Care, 24(3), e15-e17.
Hugonnet, S., Perneger, T., & Pittet, D. (2002). Alcohol-Based Handrub Improves
Compliance With Hand Hygiene in Intensive Care Units. Archives Of Internal
Medicine, 162(9), 1037.
Mahfouz, A., El Gamal, M., & Al-Azraqi, T. (2013). Hand hygiene non-compliance among
intensive care unit health care workers in Aseer Central Hospital, south-western Saudi
Arabia. International Journal Of Infectious Diseases, 17(9), e729-e732.
Sadule-Rios, N., & Aguilera, G. (2017). Nurses’ perceptions of reasons for persistent low
rates in hand hygiene compliance. Intensive And Critical Care Nursing, 6(2), 1-7.
Shukla, U., Chavali, S., & Menon, V. (2014). Hand hygiene compliance among healthcare
workers in an accredited tertiary care hospital. Indian Journal Of Critical Care
Medicine, 18(10), 689.