Promoting Hand Hygiene in Healthcare: NHS Case Study Analysis

This report provides a comprehensive overview of hand hygiene promotion in healthcare settings, with a specific focus on the National Health Service (NHS) in England. The introduction establishes the background, research aim, objectives, and research questions, emphasizing the importance of hand hygiene in preventing infections. The literature review explores the concept of hand hygiene promotion, its various benefits within healthcare, and the challenges associated with its implementation. The report then outlines the research methodology, data analysis, and findings. The conclusion and recommendations offer insights into enhancing hand hygiene practices. Finally, a reflection and alternative research methodology are presented. The report highlights the significance of hand hygiene in minimizing the transmission of pathogens, improving patient safety, and controlling antimicrobial resistance, emphasizing the need for continuous handwashing education and promotion to ensure the health and well-being of both patients and healthcare personnel. The report also touches on the importance of hygiene promotion campaigns to address misconceptions and encourage better hygiene practices.

HAND Hygiene promotion in a health
care setting
Contents

Topic - HAND hygiene promotion in a health care setting.............................................................1
INTRODUCTION...........................................................................................................................1
Background of research...............................................................................................................1
Background of an organisation....................................................................................................1
Research aim................................................................................................................................1
Objectives....................................................................................................................................2
Questions......................................................................................................................................2
Rationale of research....................................................................................................................3
CHAPTER 2: LITERATURE REVIEW.........................................................................................4
Concept of hand hygiene promotion............................................................................................4
Various benefits of hand hygiene promotion with in health care setting....................................5
Different issues or problems that are associated with the promotion of hand hygiene in health
care setting...................................................................................................................................6
CHAPTER 3: RESEARCH METHODOLOGY.............................................................................9
CHAPTER 4: DATA ANALYSIS................................................................................................13
Chapter 5: Conclusion and Recommendations..............................................................................30
Chapter 6: Reflection & Alternative research Methodology.........................................................32
REFERENCES..............................................................................................................................35

Topic - HAND hygiene promotion in a health care setting
INTRODUCTION
Background of research
Hand hygiene is way to cleaning hand that minimized the potential pathogens on hands. It is
regarded as primary measure for minimizing transmitting risk infection between the patients and
the heath care personnel’s. It is very important for individual to maintain proper hand hygiene in
order to enhance health care. Promotion of health hygiene is very important as it is significant for
providing importance or significance of health hygiene for individual. It is very important that
individual is focusing on their health hygiene as well as regularly washing hands. Hand hygiene
is considering as one of the effective way to prevent infection and it play crucial role in overall
health of a person. This support person in not getting infected as well as prevention of spreading
infection for one person to others. This report includes information regarding various aspects of
hand hygiene promotion in a health care setting. This report includes data collection form
different methods and approaches in order to gather accurate data. Hand hygiene is mainly
consisting use of the alcohol based hand rub is simple and efficient way to be prevent spread of
the infections and pathogens in the healthcare settings. Promoting the better hand hygiene is one
of the powerful tool that the people continue to be leverage to minimize spread of the COVID-
19. With the COVID-19, the transmission spreading among the people by indirect, direct or the
close contact with the infected people through nose secretions and mouth, washing hands and the
running water is necessary.
Background of an organisation
National Health Service (NHS) is publicly funded healthcare system in the England and
this is second largest single payer healthcare system in world after Sistema Único de Saúde. NHS
mainly provides the healthcare to all the legal English residents and also from the other regions
within UK with many of services are free at use point. It provides majority of the healthcare in
the England consisting the in- patient care, primary care, dentistry and long term healthcare.
Research aim
The aim of research mainly expresses aspiration or intention regarding research study. This
mainly summarise in single sentence to attain end of research project. It is necessary that
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research aim should be phrased and particular in such a manner that is possible to be determined
when this has to be attained. The aim of research is mainly developed on the basis of specific
research area. The focus of research aim is on long term outcomes of projects effectively. This
can be written in short paragraph or single sentence.
The aim of this research is “To determine the importance of hand hygiene promotion in
order to enhance health care setting practices.” Cast study of NHS.
Objectives
It explains concisely what an investigation is trying to be attained. They mainly summarise
attaining an investigation to doing project and also give proper direction to study. The research
objectives are developed on the basis of research aim. It is essential that the research objectives
may linked with statement of the purpose in study that does not have hypothesis. Developing the
clear and relevant information helps in providing the positive outcomes.
 To understand the concept of hand hygiene promotion.
 To analyse the various benefits of hand hygiene promotion with in health care setting
 To evaluate different issues or problems that is associated with the promotion of hand
hygiene in health care setting.
Questions
The better research questions are necessary to guide research paper and project. This
generally pinpoints what need to attain and provide work clear focus. It is necessary that all the
research questions should be focused on specific issue or problem. Other than this, research
questions are mainly lie at core of the systematic research and it is recording the relevant
research outcomes to asking correct questions. Asking correct questions when conducting an
investigation can assist to gather insightful and relevant information that influence work
ultimately.
 What is the concept of hand hygiene promotion?
 What are the various benefits of hand hygiene promotion with in health care setting?
 What are different issues or problems that are associated with the promotion of hand
hygiene in health care setting?
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Rationale of research
This report will include different elements that are associated with hand hygiene along with
different aspects that are crucial for promotion of hand hygiene. This is very important and
essential for individual to consider hand hygiene as well as enhance overall health of a person.
Good hand hygiene is very important for a person and it will lead to have direct impact on health
or a person. Good hand hygiene is significant for spreading infection, controlling risk of bacterial
mutational and antimicrobial resistance. This is very effective in order to make or conduct health
care practices more significantly. Promotion of hand hygiene is considering to be significant for
providing information about the benefits of regular washing hands as well as its health care
advantages. This is very effective in order to provide information to individual regarding
enhancing health care for individual. Through this researcher is able to gain information about
the advantages of hand hygiene promotion along with different issues that are associated with
this.
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CHAPTER 2: LITERATURE REVIEW
Literature review refers to the survey regarding scholarly sources on particular subject area.
this mainly gives the overview regarding current knowledge that helps in determining the
relevant models and theories in existing investigation. The aim of literature review is to attaining
research objectives in a detailed manner by consisting secondary sources. In an investigation,
researcher use literature as foundation as well as support for new insight which contribute. Its
main focus is to synthesize as well as summarise arguments along with the ideas without adding
any contribution. In conducting the literature review, there has been secondary sources used for
an instance articles, scholars, journals, internet sources and others. Narrow scope literature may
be considered as part of peer reviewed journal article that presenting the new investigation,
serving to present study. Process of reviewing literature needs various kinds of the activities as
well as thinking ways. Procedure of reviewing literature is ongoing and also informs several
aspects of empirical investigation project. The literature review is mainly conducted on HAND
hygiene promotion in a health care setting.
Concept of hand hygiene promotion
According to opinion of Patrick Boshell (2020) Hand hygiene is way to cleaning the one
hand that generally reduced the pathogens on hands. Hand hygiene process consists use of the
alcohol based rubs and the hand wash with water and soap. Alcohol containing preparation that
designed to hands to be inactive microorganism and suppress growth. It is general term that
mainly applied to handwashing, surgical hand antisepsis and the antiseptic hand rub. The better
hand hygiene is necessary aspect to protect an individual from the transmission of infections.
This is most effective and better way to prevent the hospital care related infection rates. In
regards to this, failure to perform better hand hygiene is regarded as leading cause of the
healthcare related to the information s and also spread of the multi resistant organisms. Washing
hands with the water and soap is recommended for the siled hand and it is better way to
overcome of germs in many situations. If water and soap are not available, then they can use
alcohol based hand sanitiser that mainly contain the 60% alcohol. Theses sanitizers are better
approach to minimize infections spread from one individual to the other. The infectious disease
is mainly continuing to health challenge along with the economic burden with communities. The
hand hygiene education is necessary as there has been the steady reduction in the hygiene
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promotion mainly in home. Impact of the poor hand hygiene habits are related to enhance
occurrence of the absences and the illness related to the costs. Continuous handwashing is better
way to remove the germs, avoid to getting sick and also prevent spread of the germs to other
people. Washing hand in proper manner is better thing to control as well as prevent of several
illnesses. Better hand hygiene will minimize risk about food poisoning, flu and some of the
healthcare related infections which being passed from individual to individual. In the COVID-19
situation, people are advised to observe the physical distancing and also better hygiene habits
that amidst pandemic. Simple practice regarding handwashing with water and soap is better way
to prevent from the virus and germs. COVID-19 has emphasised significance of the handwashing
with soap to minimize virus spread. This pandemic situation mainly reinforces significance
regarding handwashing with soap to assure way of preventing the infection from the infectious
disease for an instance common cold, Lassa fever, foodborne disease and some of the other
gastrointestinal disorders. To promote the awareness regarding hand hygiene, it is necessary to
conduct the campaigns to yield the positive outcomes from response of government to
humanitarian space and from the professionals whose duties are to be overlap in health sector.
https://info.debgroup.com/blog/hand-hygiene-at-home-and-school
Various benefits of hand hygiene promotion with in health care setting
On the basis of Corey Whelan (2020) hygiene promotion may be used to assists affected
people to neglect and also limit extraordinary hygiene risk that developed through emergency
situation as poor sanitation. The main objective of the hygiene promotion is to assist people to
understand as well as develop better hygiene practices to prevent disease and also promote the
positive attitude towards cleanliness. This is dialogued with the communities regarding hygiene
and some other health related issues to encourage the improve hygiene practices. In regards to
this, hygiene promotion messaged along with the activities mainly address the misconceptions
and behaviours that target the all group people. Hand washing before the administering medicine
can be prevent or reduce disease spread. Main purpose of washing hands is to be cleanse
pathogens hand as well as chemicals which can cause the harm. It is necessary to rinse hands
under the running water at comfortable temperature. The warm water is not more effective than
the cold water at killing germs. Germs from the unwashed hands can transferred to some other
objects transferred to the hand of other individual. Removing the germs by handwashing aids in
prevent from the respiratory infections and diarrhoea and this many prevent the eye and skin
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infections. Campaigning can be helpful in develop collective and energy and this is helpful in
creation of movement of people and the groups in common cause. Clean hands are helpful in
preventing spread of the germs directly or indirectly by hand to the surface contact. Numbers in
the healthcare environments are more troubling with similar percentage of the employees self-
reporting regarding the hand washing related practices. It is necessary to was the hands after or
before interact with the patients. Washing hands is beneficial for person to stop germs from
entering bodies by mouth, eyes and nose. It prevents from the disease for an instance influenza
and diarrhoea. Prevent any disease considerably communicable disease as well as bacterial
infections.
As contrary to this….. this is easy for the people who are monitored closely to keep hands
clean with the constant reminders. Adults who mainly caught up with daily basis activities have
high tendency to be overlooked hand washing. Knowing positive impact of the handwashing on
life of an individual is better motivating factor in order to maintain the better hygienic habits.
Other than this, there are different advantages of the handwashing promotion mention below:
Developing safe working environment- In this, nature of the several types of the medical
process is delicate. This mainly deals with the exposed passing drugs or internal organs into
body. In specific cases, hand washing needs to be taken on serious basis because harmful
bacteria can get into the bodies to cause the more harm. Better medical facilities have basic
facilities for the hand washing accessible. These are the facilities should mainly use on regular
basis through patients, visitors and doctors. Those facilities are requiring to be sanitary and soap
dispensers and some of the other items which require to replenished on regular basis. Efforts
regarding safe working environment consists more thorough and hand rubbing than this this is
expected from some of the staff members.
https://www.healthline.com/health/washing-hands#tips
Different issues or problems that are associated with the promotion of hand hygiene in health
care setting
Health are related infection arise globally and affect both developed and resource poor
nations. Infections obtained in health care setting are between the main reasons of death ad
maximised morbidity in hospitalised patients (Boyce, 2019). They represent an importance
burden for both the patient and their family and for public health. In resource-poor nations,
where the health system requires to deliver care to a population with lower health status and to
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cope with the lack of human and technical assets, the burden of health care linked infections are
the cause of death for the whole population. According to CRNA R. N. (2020), HCAI is a
problem which in present time faced by all health care services across the world regardless of
economic state. Not only does it concession patient safety but also that of HCWs. It is the
interest of all health care providers to address the situation and make sure developed patient
safety as well as make suitable work atmosphere for workers. Most especially since the
unfavourable influence and problem with the promotion of hand hygiene in health care consider
as excessive costs for patients, maximised resistance to antimicrobials and a higher economic
burden for the community as a whole (Loftus and et. al., 2019). Number of the health care
providers in LIC is suffered through a combination of diverse determinants due to a higher
transmission threat of HCAIs. These might consider understaffing, poor infrastructure with
lacking hygiene and sanitation situations, lack or shortage of basic equipment, patient
overcrowding all of which can be connected to limited economic resources.
There are some other issues which are associated to hand hygiene in the healthcare setting.
Gloves, the use of gloves in health care setting has increased in current era due to COVID 19
pandemic. The utilisation of gloves is suggested to minimise contamination of the hands with
flora that may be transferred to patients Information that globes can prevent hands from
becoming polluted with microorganisms both from the patients and the inanimate atmosphere is
offered by different studies. It is crucial that hands are secured from becoming contaminated as
hand hygiene activities are not always successful in removing all pathogenic organisms when
hands are heavily contamination it is not basically potential to acknowledge how many organism
have been obtained and the subsequent risk of transmission. The use of gloves is one of the main
issues which affect the promotion of hand hygiene in health care in term of hand wash. Because
when people make high focus on use of gloves then they do not centring on washing their hand
with hand wash in more effective manner (Hand hygiene: simple and complex. 2020). There are
several developments in glove technology have considered the incorporations of microspheres in
to gloves that discharge chlorine dioxide when activated through light or moisture and double
layered gloves that offer extra protection when staining sensitivity. It is not acknowledged that
what influence these innovations will have on future hand hygiene suggestions.
Hand creams and emollients are some other issues which create barriers in term of
promotion of hand hygiene in health care setting. Dry hands are a frequently reported problem
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between HCWs who are needed to wash or fumigate their hands frequently. Lipids contribute to
the barrier function of the skin creams, lotions and emollients may maximise the skin hydration
and further add to the protection of skin. There is also apprehension that oil based commodities
may inhibit the barrier function and the efficiency of antimicrobial agents utilised in hand
hygiene practices. Hand hygiene policies suggested that sleeves should be rolled up before hand
hygiene procedures as they also create barriers in promotion of hand hygiene in health care
setting. Most uniform policies also suggest short sleeves, though short sleeves are not basically
implemented for HCWs who do not wear uniforms. It would be expected that wet sleeves, in
ordinary with any moist surface, could act like a pool for microorganisms that could then be
transferred to hands by instant contact (Lee and et. al., 2019). The subungual area contains wide
amount if bacteria that are widely inaccessible during hand hygiene activities and are thus
complex to clean compared with the rest of the hands, Most infection control directions suggest
that fingernails are kept short, This makes easy cleaning but is has also been demonstrated that
longer nails have maximised number of microorganisms.
Artificial nails are highly reported as having the possible to transmit infections in the healthcare
setting. Artificial nails are more probable to be colonised with Gram negative bacilli and yeasts
than natural nails. Other forms of nail art and technology have become famous in several nations
and have currently analysed in reference to hand hygiene in HCWs. In current time, people
highly make focus on artificial nail, nail art and many more kind of things which is one of the
barrier and issues which affect the promotions of hand hygiene. Cause of which there is several
possible health issues, considering local infection for people who have undergone some form of
nail technology. There is also potential risk that these activities may pose a problem to patients
and in other critical area like food sector. Temporary tattoos on the hands are a problem which
also affects the promotion of hand hygiene. These kinds of tattoos are designed with henna and it
is not unusual for female HCWs in different nations (Alzyood and et. al., 2018). Apart from all
these, fund and finance is the key factor which affect the promotion of hand hygiene because in
this current corona virus pandemic the use of hand wash and hand wash related material’s
demand is high so different companies which offer these kind of products maximise the cost of
hand hygiene products which highly affect the use of hand wash related commodities.
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CHAPTER 3: RESEARCH METHODOLOGY
This is referring as the procedure or process which is consider by researcher in order to
successfully or effectively conducting research practices. It is very important that research
methodology practices are successfully performed as it assist in better decision making along
with this completing all task in accurate manner. It can be describing as the particular systems or
methods used to distinguish, select, measure, and dissect data about a subject. In an exploration
paper, the philosophy area permits the researcher to fundamentally assess an examination's
general legitimacy and dependability. Research methodology includes various elements that is
helpful for providing guidance and direction to correctly perform research practices along with
this taking correct or accurate decisions.
Research philosophy – This is considering as very important part of research practices as it is
the belief on which different practices of research will be performed. It is resolved as a way of
thinking which is utilized by a scientist while gathering data identified with the subject of
exploration as through that they ready to gather more verify just as dependable data in a
successful way. There are two sorts of examination methods of reasoning, for example
positivism as well as interpretivism research philosophy.
Justification: In regard of this task, the investigator is considering positivism research
theory since that help in agreement is gathering data in a legitimate way, which prompts getting
want result effectively. This research philosophy will be more significant for researcher as it will
help in taking better decision to successfully conduct research practices.
Research approach – This is referring as the process or plan that includes step of assumption in
order to detailed methods of data collation, analysis as well as interpretation. It is considered as
cycle or plan which considered stage identified with the expansive suspicions of the itemized
approaches for social affair data and assessing it appropriately so analyst will get the fitting
result. There are chiefly two sorts of exploration draws near, for example inductive, and
deductive exploration draws near. In regard of this exploration venture, the specialist is
executing inductive examination approaches as through that they ready to gather more validate
just as dependable data identified with the theme. In inductive research approach known
premises are used with the motive of generating untested conclusion. Through this approach data
collection can be used to explore a phenomenon, identify theme as well as patterns in order to
create a conceptual framework.
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Justification: In conducting the present investigation, deductive research approach has
been used. The main reason to use deductive approach is that it provides the general to specific
information. This research approach examined possibilities to reach at the particular as well as
logical conclusion. The deductive research approach has been used as it is suited to work with
the quantitative data. Process consists reproducing previous study and also seeing if similar
outcomes are to be produced.
Research strategy- It is step by step action plan that produce the direction to efforts and
thoughts enabling to conduct the investigation in systematic manner. It schedules to produce the
quality outcomes and reporting. This introduces major components of research project for an
instance topic area and research perspectives. Research strategy is systemic process of how an
investigation is conducted to solve inquiry issue.
Justification: In this present investigation, survey has been considered the better research
strategy as it is cost saving and the time saving. The surveys consist small cost as per the
respondents as this can be developed in minimum time period. Benefit of the survey consist
having large population and effective statistical power, ability collect more information and
having validated models availability. From the survey, data collection is easier with the surveys
that tend to use easier to read the data sources which can examined as required for an
investigation.
Research method– This is viewed as a technique or instrument which is embraced by a
specialist to accumulate more validate just as dependable data. There are commonly three
examination techniques which are received by the researcher for example qualitative,
quantitative just as mixed research methods. Quantitative research can be describing as the
method of gathering data in more systematic and accurate manner. Through this research
method, investigator will be able to collect or gather data from different sources. In this data or
information can be represented in for numerical or statically form. This is easy to understand and
analyse data. Qualitative research is effective way of gathering or collecting in depth information
about the any topic. In qualitative research method investigator is focus on gathering information
from the opinions, reviews, experiences and so on.
Justification: In regard of this research project, the investigator is receiving quantitative
research strategies as through that they can accomplish or accumulate information or data which
are mathematical and measurable based. Moreover, for quantitative technique researcher may
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