NSD203 Assignment: Barriers to Effective Hand Hygiene

This report, prepared for the Inquiry in Clinical Practice unit, investigates the barriers to effective hand hygiene practices among healthcare workers in Australia. The report begins with an introduction to the importance of hygiene and handwashing in healthcare settings, followed by an appraisal of evidence from two articles discussing the barriers to hand hygiene, including heavy workloads, time constraints, poor sink installations, and water irritation. The report then analyzes the gaps in the provided articles, the bottom-line statements, and provides recommendations based on the findings. The second part of the report reflects on the learning about Evidence-Based Practice (EBP), including the EBP processes, quality, and its relevance to future nursing practice. The report highlights the importance of EBP in improving patient care and reducing the risk of infections, emphasizing the need for healthcare professionals to prioritize patient needs and apply EBP procedures in their practice.

Running head: INQUIRY IN CLINICAL PRACTICE 1
Inquiry in Clinical Practice
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INQUIRY IN CLINICAL PRACTICE 2
Introduction
Hygiene is the basic practice that people are taught since their childhood. Different
cultures throughout the world have been having different approaches towards how a person
should perform this action. However, due to the advancement in technology and the spread of
knowledge between the cultures, different approaches have been laid out to improve this aspect.
Different people, as a result, have been informed to practice these actions through several types
of hygiene. These types include the oral, body, face, hair, foot, and handwashing hygiene among
many others. Here in Australia, we have been facing several issues on how handwashing hygiene
should be carried out. As a matter of fact, this essay shall focus on two sections that will be an
appraisal of evidence and the reflection on the learning about the evidence-based practice.
Part ONE: Appraisal of evidence
Different authors have presented the issue on handwashing barriers that our health care
officials face here in Australia. Their thoughts have included in the following description.
1) Controlling Infection Through Correct Hand Hygiene
a) Summary
In this article, as written by The Australian Hospital Healthcare, several thoughts on
handwashing actions have been explained (The Australian Hospital Care, 2015). It starts by
indicating the importance of handwashing among the healthcare officials in saving the lives of
the patients that they attend to. This is because most of the patients that are not taken care of
effectively by their caregivers end up suffering from in-hospital related ailments. The article
proceeds and indicates that handwashing practice by these officials helps in the reduced price of

INQUIRY IN CLINICAL PRACTICE 3
healthcare across the nursing sector. This fact is because it is a cheap action as well as a quick
one that does not involve any manipulation of resources.
b) Gaps
In this article, the authors have described several factors that are the barriers to effective
handwashing including the following. The first barrier included the heavy work that the health
professionals had to handle. For instance, a health care professional may be loaded with too
much work in his or her respective working zone. As a result, the person will always have very
short time to care about the little things such as washing his or her hands which is a key action in
nursing. Secondly, the article described that healthcare providers face the problem of perception
that handwashing consumes a lot of time (Campbell, 2017). Having such a perception changes
the attitude that the professional nurses and their respective workmates have towards the action.
For instance, healthcare providers may simply be in a hurry to serve a starving patient with his or
her food. However, they fail to wash their hands while serving the meals. As a result, the patient
may be infected with new ailments such as typhoid (Hirschhorn, et al., 2018). The third barrier
that this article puts to light is the poorly installed handwashing sinks. Poor installation of the
water sinks may result in the worsening of the working conditions for these working
professionals. Thus, many nurses and other caregivers will simply prevent themselves from
washing their hands in order to avoid further infections. Finally, the article describes that the
irritation that the water may come with while the caregivers are washing their hands may cause
them simply to avoid washing their hands. The causes of the water irritation may be germ
infection or mixture with other solutions such as acids and/or farm chemicals (Komar, et al.,
2017). This fact makes the nurse professionals not want to wash their hands over multiple times
during their duty performance.

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c) Bottom line statement
The above factors will simply make the nurses be reluctant from washing their hands.
d) Recommendation
The author in this article starts with the description of how the whole world suffers from
contamination related to infection transmission. However, he shifts his focus locally to Australia
forgetting to include data from other places and how much care has been delivered to such
places. My recommendation would be the author to critically perform more research and provide
more data on other places suffering from the same infection.
2) Hand Hygiene and Infection Control – How Effective Handwashing Can Save Lives
a) Summary
In the second article, the author, Zoe Hughes, highlights the Work Health and Safety Bill
that is all about the protection of health care nurses and their stakeholders from further infection
(Hughes, 2017). The author goes on and indicates that the bill requires these nursing
professionals to thoroughly wash their hands as it aids in meeting its objectives. In a short
summary given by the author, he indicates that 20 hospitals, in Australia, were engaged in a
research on handwashing and the outcome it has on the reduction of disease transmission. The
author reports that the hospitals had a correlating record between the handwashing and the
reduction of the infection transmission (Weaver, 2015). In summary, he indicates that those
hospitals that consistently washed the nurses’ hands had a good record of close to no infection
transmissions when compared to those that did not.
b) Gaps

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In this article, the author gives a record of the causes of infection in the hospitals
including the following. He starts with the presence of bacteria, then cross-contamination, and
then the transmission to the patients. The process that the transmission of the bacteria has been
through the presence of the bacteria, the bacteria landing on the hands of the care professionals
and then directly coming into contact with the patients (Johnson, 2018).
c) Bottom line statement
In conclusion, the author indicates that the World Health Organization, WHO, has
established the guidelines that every nursing professional must use for the best health of the
patients visiting the care facility.
d) Recommendation
The author does not indicate that causes of the delay in the handwashing of these nursing
professionals. Thus, my recommendation would be the author to critically do more research on
the causes of the failure of these nursing professionals.
Part TWO: Reflection on learning about EBP
From part one above, I have learned that there are a number of barriers that prevent the
nurses from effective handwashing. However, I have noticed that there are other risk factors that
are associated with the poor hand hygiene including nurse’ status, wearing gloves, the automatic
sinks, and working on the intensive care units (Pawlikowski, Rico, & Van Sell, 2018). On the
other hand, I came to understand the full evidence-based practice at its application in hand
hygiene as described in the following.
a) The EBP processes and quality

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The evidence-based practice has a number of steps including asking the relevant
questions, seeking the best solution, and the critical appraisal of the evidence. It also has the
integration of the nurse’s capabilities with the clinical expertise, outcome evaluations, and
assessment of the outcome. This process enables the nurses to not only wash their hands
effectively but also to understand the nursing value it has to the patients (Schober, 2016). As a
result, the quality of the care being delivered to the patient will always be high as they are
considered first by not contracting further infection to them.
b) EBP relevance in my future nursing practice
The employment of the EBP in the nursing sector facilitates better care to the patients. On
my personal side, I will be able to use the EBP procedures in making the best solutions out of the
most relevant questions and situations I may face. I will able to consider what the patients need
most instead of my desires first (Gibson & Markovic, 2015). In addition, I will be able to
improve the health conditions of these patients since they will be less exposed to further
infections contracted from the clinic.

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References
Campbell, W. T. (2017). Early Evidence-Based Practice (EBP). Florence Nightingale and the
Pavilion-Style Hospital.
Gibson, B. E., & Markovic, D. (2015). A Systematic Review: Immediate and Maintenance
Effects of Interventions on Handwashing Compliance in Healthcare Workers.
Hirschhorn, L., Krasne, M., Maisonneuve, J., Kara, N., Kalita, T., Henrich, N., et al. (2018).
Integration of the Opportunity‐Ability‐Motivation behavior change framework into a
coaching‐based WHO Safe Childbirth Checklist program in India. International Journal
of Gynecology & Obstetrics.
Hughes, Z. (2017, August 21). Infection Control – How Effective Hand Washing Can Save Lives.
Retrieved 2018, from Ausmed: https://www.ausmed.com/articles/hand-hygiene/
Johnson, S. (2018). Combating hospital-acquired c. diff. Nursing management, 16-22.
Komar, J., Kovacic-Mauer, V., Gardner, L., & Popik, M. (2017). Hand Hygiene to Prevent
Infections. Journal of PeriAnesthesia Nursing, 32(4), e31-e32.
Pawlikowski, P., Rico, N., & Van Sell, S. (2018). Positivism: A Concept Analysis.
Schober, K. (2016). Implementation of Infection Control Bundle in a Freestanding Inpatient
Rehabilitation Facility.
The Australian Hospital Care. (2015, August 19). Controlling Infection Through Correct Hand
Hygiene. Retrieved 2018, from The Australian Hospital Care:

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https://www.hospitalhealth.com.au/content/nursing/news/controlling-infection-through-
correct-hand-hygiene-196205954#axzz5UBKamxtv
Weaver, L. L. (2015). Effectiveness of work, activities of daily living, education, and sleep
interventions for people with autism spectrum disorder: A systematic review. American
Journal of Occupational Therapy, 69(5), 6905180020p1-6905180020p11.