NURSING: Examining Hand Hygiene Practices and Infection Control

This essay discusses the significance of hand hygiene in reducing healthcare-associated infections (HAIs). It begins with a PICOT question focusing on the impact of hand hygiene guidelines on HAI rates compared to unhygienic practices over six months. The author reflects on their initial understanding of HAIs, which was limited to surgical settings, and how research broadened their perspective to include various infection types and the importance of hand hygiene across all medical wards. The essay highlights the role of hand hygiene in patient safety and the need for healthcare workers' compliance. It references two peer-reviewed articles that examine hand hygiene educational programs and the availability of handwashing facilities. These articles shaped the author's understanding by emphasizing the importance of hand hygiene for both healthcare workers and patients in all medical wards, not just surgical settings. The essay concludes by noting that factors like behavior, work environment, and cognition influence hand hygiene compliance, suggesting that social learning and cognitive theories could inform educational programs. The author also identifies alcohol-based hand rubs and the WHO's five moments of hand hygiene as effective tools for improving handwashing practices and patient safety. Desklib provides access to similar essays and study resources.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the student:
Name of the University:
Author note:

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PICOT:
Population (P) Health care workers
Intervention (I) Using hand hygiene guidelines
Comparison (C) Unhygienic practice
Outcomes (O) Reduction in healthcare associated infections
Time (T) 6 months
PICOT question:
Does the use of hand hygiene guidelines reduce the risk of healthcare associated
infections as compare to the unhygienic practice within a time period of 6 months?
Before conducting the preliminary research of academic literature on the effectiveness
of hand hygiene on the reduction of health care associated infections my personal perception
regarding the issue was health care associated infections only develops for the patients
undergoing major surgery. I believed that, maintaining proper dressing and medication is the
only process of managing surgical infection. However, I was aware about the importance of
using aseptic process during surgery and surgical infection management, but the transmission
of infection through unhygienic process such as lack of hand hygiene was not fully
understood. I considered the hand washing or hygiene process as a common process but was
unaware about its effectiveness in reducing health care associated infection. However, during
the research of academic papers I gathered information about health care associated infection
and demonstrated the importance hand hygiene. Furthermore, I have learned about different
factors related to health care associated infection such as infection associated with wound,
intravenous channel related infection, infection due to the transmission of microbial agents

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and others and understand the importance hand hygiene compliance of the health workers
(Smiddy, O'Connell & Creedon, 2015). I have realised that, hand hygiene is not only
important during surgery or surgical infection management but also for reducing risk of other
health care associated infections and its importance in usual care. In addition importance of
hand hygiene of patients is also understood during the research (Haverstick et al., 2017).
The significance and relevance of hand hygiene in reducing health care associated
infection in nursing is high. Research has identified health care associated infections as the
reason of morbidity and mortality across the world, thus become one of the major threat for
patient safety (Luangasanatip et al., 2015). Hence, it is required to implement effective
strategy in order to reduce the risk of health care associated infections in an effective manner.
In this regards, hand hygiene compliance has been identified as an effective technique to
reduce the transmission of health care associated infections (Monistrol et al., 2012).
However, health care workers have found to be poorly complies with hand hygiene factors
due to lack of information and understanding regarding the importance of hand hygiene.
Thus, it is important to provide adequate information to the health workers about the
effectiveness of hand hygiene in reducing health care associated infections and it is important
to make them understand that it is the safety belt for them as well, so that they could comply
with the hand hygiene guidelines (Niyonzima, Brennaman & Beinempaka, 2018). Hence,
research on this topic would help to reduce the risk of health acre associated infection and
improve the quality of life by ensuring patient safety. This position is also supported by the
recent study conducted by Smiddy, O'Connell & Creedon, (2015) who suggest that research
is required to explore the factors that influence hand hygiene compliance to use them to
encourage the health workers to comply with hand hygiene guidelines in order to reduce the
risk of healthcare associated infection and improve patient safety.

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In a preliminary research of academic papers, two peer reviewed articles have been
identified using database such as Google Scholar. Relevant key terms such as healthcare
associated infection, hand hygiene, patient safety has been used with inclusion criteria such
as English language, current year, relevancy and full text articles. As mentioned before, it is
important to educate the health workers about the effectiveness of hand hygiene compliance
in order to motivate them to follow the guidelines. The article by Monistrol et al., (2012) has
focused on hand hygiene educational program and used interventional methods to derive the
result which has provided basic ideas about the strategies that could be taken to implement
educational program, thus, the study has been found to be relevant to the research topic and
the article has been selected for the research. On the other hand, the article by Niyonzima,
Brennaman & Beinempaka, (2018) has provided evidence based practice related to hand
hygiene and examined its effect on different medical wards such as surgical ward, ICU, ED
and general ward as well, thus, wide range of area has been undertaken. Due to such reason
this article has been selected for the research.
The identified purpose of the article by Monistrol et al., (2012) is to evaluate the
effect of a multimodal intervention on hand hygiene compliance, alcohol-based hand rub
consumption and incidence of health care associated infection and hospital-acquired
methicillin-resistant Staphylococcus aureus in medical wards. On the other hand the
identified purpose of the article by Niyonzima, Brennaman & Beinempaka, (2018) is to
assess the availability and suitability of required hand washing facilities, hand washing
practice and compliance among healthcare workers in surgical ward, emergency department,
ICU, and general wards.
The two articles have shaped my original understanding. My original understanding
was that, hand hygiene is maintained only in surgical ward to reduce the risk of surgical
infection and it is only performed by the health workers, however, the articles have

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contradicted my knowledge and informed that it is important to comply with the hand
hygiene guidelines for health workers and patients as well in every medical wards such as
surgical ward, ED, ICU and general ward to reduce the risk of health care associated
infection and reduce the transmission of infection (Niyonzima, Brennaman & Beinempaka,
2018). Beside the safety of the patients, hand hygiene provides safety to the health workers as
well. Behaviour of the health workers, work environment and cognition of individual have
been found to impact the compliance with hand hygiene, hence social learning theory and
cognitive theory would be helpful to initiate an educational program. In addition alcohol
based hand rub consumption has been indicated as effective technique as compare to using
soap. Furthermore, five moments of HH of WHO is also an effective tool to inform about the
hand washing practice and improve patient safety (Monistrol et al., 2012).

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References:
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017).
Patients’ hand washing and reducing hospital-acquired infection. Critical care
nurse, 37(3), e1-e8.
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: systematic review and network meta-analysis. bmj, 351, h3728.
Monistrol, O., Calbo, E., Riera, M., Nicolás, C., Font, R., Freixas, N., & Garau, J. (2012).
Impact of a hand hygiene educational programme on hospital-acquired infections in
medical wards. Clinical Microbiology And Infection, 18(12), 1212-1218. doi:
10.1111/j.1469-0691.2011.03735.x
Niyonzima, V., Brennaman, L., & Beinempaka, F. (2018). Practice and compliance of
essential handwashing among healthcare workers at a regional referral hospital in
Uganda: A quality improvement and evidence-based practice. Canadian Journal Of
Infection Control, 33(1), 33-38.
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.