System04104: Hand Hygiene Literature Review on Infection Risks

This literature review, focusing on System04104, explores the critical importance of hand hygiene in healthcare settings. It highlights the significance of hand washing in preventing infectious diseases and reducing the risk of bacterial transmission between patients and healthcare staff. The review emphasizes the five key moments for hand hygiene, as recommended by the WHO, including before patient contact, before aseptic procedures, after body fluid exposure, after touching a patient, and after contact with the patient's surroundings. It references various studies and guidelines to underscore the necessity of hand hygiene practices to maintain a safe and hygienic environment, particularly in the context of potential risks like the spread of viruses and bacteria. The review also discusses the benefits of hand hygiene in improving global health and patient safety. Furthermore, the review emphasizes the importance of proper hand hygiene techniques and the use of alcohol-based sanitizers or soap and water. The review provides a comprehensive overview of hand hygiene practices and their impact on infection control in healthcare settings, supported by several research papers and guidelines, and concludes with a call to action for consistent hand hygiene practices in healthcare facilities.

Running Head: Hand Hygiene
Hand Hygiene
Literature Review
System04104
1/30/2020

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Introduction
Hand hygiene or washing hands is the best way of avoiding infectious disease and
removing germs from hands that makes people more healthy and safe. It is really important or
people to take hand washing more seriously and include it in their daily routine before eating
and after using toilet. However, hand hygiene has a great importance in the field of healthcare
because the chances of transmitting bacterial infection are very high from patient’s contact to
staffs or to their own family members. There are varieties of way to wash hands and follow
the hand hygiene processes and way to stay healthy. However, this literature review helps to
understand the importance of washing hands and discusses five evidences of hand hygiene
moments to manage the infection risk.
Stahmeyer, Lutze, Von Lengerke, Chaberny, & Krauth, 2017 also mentioned that
bacterial infection in healthcare profession is very usual because large numbers of people are
infected with disease and infection can be easily transmitted to one person to another person.
Bacteria can also transmit from an ill person to a healthy person in a healthcare organisation
or people who are working in healthcare profession. The recent case of Corona virus in
China, which is transmitting from animals to humans, is the big example of spreading
bacteria from one thing, species, or objects to another thing or humans. However, in such
cases washing hands or hand hygiene is a good practice to avoid corona virus or any type of
bacterial infections (Stahmeyer, Lutze, Von Lengerke, Chaberny, & Krauth, 2017).The
another incident of benefit of hand hygiene can easily be noted when people in healthcare
profession deal with body fluid. After procedural activities, the body fluid exposure risk is a
serious concern in which hand can be contaminated with harmful and effective body fluids.
Even the doctors or nurses wear the gloves, it cannot be stated that people avoid the risk of
bacterial infections or germ transmission (Boyce, 2011).

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Literature Review
The most common place where bacteria can easily spread is bathroom in home and in
healthcare organisations in public places. It is really important in medical profession to care
about the hand hygiene because the chances of transmitting bacteria or germs are very high.
There are varieties of reasons behind healthcare organisations, which is a thriving place for
bacteria (McGuckin & Govednik, 2013). There are many easy ways to wash hands and keep
it clean. Some of them are washing hands from soap or water or from any hand-wash liquid
and second is using alcohol based sanitizers to remove germs from the hand.
It is really important for the people to know about the benefit of using sanitizer or
habituate to wash hands on regular basis to avoid infectious diseases and keep the
environment safe and properly sanitised in the healthcare profession because it is one of the
most sensitive place for the bacterial infection. Boyce (2011) mentioned in the article that
hand hygiene practice is very important in healthcare profession as it helps the people to stay
away from the germs and infected disease. There are large numbers of incidents in healthcare
profession where patient is more infected than felt serious than the disease. It is universal and
known to every people that bacteria spread everywhere and even bacteria reside in the human
body. It is also crucial to know that not all bacteria are harmful for the human body rather
some of them are useful for the people while some of the bacteria are very dangerous for the
human health. However, if the harmful bacteria spread or take over the immune system of our
people, people may become ill (Stahmeyer et. al., 2017).
According to WHO, the major advantage of hand hygiene is to improve global health
and it helps the world to provide a healthy environment for the humans. WHO has initiated
large numbers of campaigning all over the world to achieve global health and millions of

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people joined the campaign to aware and educate people about the importance of hand
hygiene or washing hands from soap.
(Source: Abdella et. al., 2014)
Stahmeyer et. al., (2017) included in his journal article that WHO focuses on educate
people about hand washing after using toilet or before eating meals because these are the two
timing when people can be more effected by the bacterial infections. However, the five
evidence moments when hand washing or hand hygiene is required in the medical profession
is required are as follow:
The first incident is related with the patient safety and security. It has been seen that
patient can easily involve in transmitting bacterial infections from one person to another
person. A patient who is suffering from any infectious disease is the perfect way of
transmitting bacteria to another person. Washing hands before entering in the patient zone is
also necessary to avoid bacterial infections and acquiring germs from the surroundings of the
patients. It is also necessary to protect the patient from outside bacterial infections. According
to Abdella et. al. (2014), it has been seen that when outsiders meet the patient they touch the

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patient through handshake or help the patient to move one place to another place, touch
medical devices that is connected with the patient. In such a scenario, the chances of
transmitting bacterial infection or transmission of germs increases to outsiders to patient or
even patient to outsiders. Therefore, to prevent such type of bacterial transmission, it is
necessary to follow hand hygiene or washing hands before touching patients (Tejada &
Bearman, 2015).
The second incident is related with the cleanliness and touching equipment, which are
implanted or connected with the patient. It is also necessary to understand that once hand has
been washed them what needs to be touched or what needs to be not touched by the people
around the patient. Once hand hygiene has been performed, the people should not touch
anything in the patient’s environment such as equipment’s, bed, patient`s body etc. It is also
necessary to protect the patient from potential pathogens. It has been seen that avoiding
touching infected equipment can stop the transmission of bacterial transmission. Abdulsalam,
Ibrahim, Michael and Mijinyawa (2015) also mentioned in their journal article that hand
hygiene protects the nurses, people, relatives of patient, and patient itself from the bacterial
infections or germ transmission. It is also seen that sometimes doctors perform the medical or
surgical procedures such as wounds dressing, surgical procedures, and burns dressings, etc.
and made with non-intact skin interface with the patients. This causes transmission of
bacteria from doctor to patient or patient to doctor. Therefore, hand hygiene during before
aseptic procedures is also necessary in the health organisation or during the treatment of
patient (Souza, Ramos, Becker, Meirelles & Monteiro, 2015).
The next evidence has been seen when people infected with the body fluids, which are
related from the patient. After procedural activities, the body fluid exposure risk is a serious
concern in which hand can be contaminated with harmful and effective body fluids. Even the

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doctors or nurses wear the gloves, it cannot be stated that people avoid the risk of bacterial
infections or germ transmission. In medical profession, it is really essential to care about
body fluids while holding or handling it during the patient care in the medical profession
(Randle, Firth, & Vaughan, 2013). It has been seen that the people or staff who are contact
with the body fluid such as urinal packet or bedpan, contact with sputum either directly or
indirectly, or use the patient cup of sputum or tissue, touch pathology samples, or cleaning
spills or urine usually need to wash their hands after these activities or touching the body
fluids. However, hand hygiene is the essential process or habit after in contact with body
fluids. There are various types of body fluids that can cause infectious disease such as
sputum, blood, urine, semen, tears, wax, breast milk, saliva, etc. People who work in
healthcare organisation must care about these things and should wash their hands after
contact with these body fluids (Bukhari, et. al., 2011). The awareness and proper precautions
can stop to enhance the chances of spreading infectious disease.
The next evidence has been reported when staff or medical practitioners come in
contact with other person after touching the patient. Washing hands is really an important
factor after leaving the patient one because patient zone might be filled with bacterial
infections. A person who leaves in patient zone is a most favourable person to be infected
with the bacterial disease and virus (Lebovic, Siddiqui & Muller, 2013). Therefore, the
modern healthcare organisations all over the world focusing on hand hygiene that improve
the health in people and stop the bacterial infections. Most of the countries around the world
focus on patient safety and care in hygienic environment. A direct communication with the
patient increased the chances of bacterial infections and that is why it is required for the
people to follow hand hygiene after exit from patient zone. Therefore, in every country,
WHO recommends through its health organisations and workers to wash the hands after

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contact with the patients without caring about the seriousness of disease (Eiamsitrakoon,
Apisarnthanarak, Nuallaong, Khawcharoenporn, & Mundy, 2013).
The fifth evidence of hand hygiene moment in medical profession has been observed
when staff comes in touch with the patient surroundings. It has been observed after touching
the patient surroundings, it is also essential for the healthcare workers or people who are in
close contact with patients to wash their hands with an alcohol liquid sanitizer or with soap
(Abdraboh, Milaat, Ramadan, Al-Sayes, & Bahy, 2016). In various researches, it has been
described that after touching the patient surrounding or infected people’s thing such as bed or
cloths, the chances of infection is generally increased. However, the chances of transmission
of bacteria from one person to another person generally increased in unhygienic environment
where germs can freely spread to one place to another place. Apart from the five moments of
hand hygiene, it is also necessary to care about cleanliness and hygienic environment in the
healthcare organisation or even in the home, especially in the bathroom and during eating
foods (Scheithauer & Lemmen, 2013).
In conclusion, WHO five moments of hand hygiene is most famous and popular in
healthcare organisations and these organisations generally ensure that all staff understand the
importance of hands hygiene and make it practice in their daily healthcare services. The five
evidences of hand hygiene moments also help the people and healthcare staff to understand
when they have to wash their hands and follow the required hand hygiene opportunities. The
five evidence of hand hygiene moments also help the medical professional and people to
avoid the risk of infectious disease such as corona virus disease, which is widely spread in
China and Middle East Asian Countries. Understanding of these five evidences of hand
hygiene moments also help in proper risk management against the infectious diseases, which
spread, from the germs and bacteria.

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References
Abdella, N. M., Tefera, M. A., Eredie, A. E., Landers, T. F., Malefia, Y. D., & Alene, K. A.
(2014). Hand hygiene compliance and associated factors among health care providers
in Gondar University Hospital, Gondar, North West Ethiopia. BMC public
health, 14(1), 96.
Abdraboh, S. N., Milaat, W., Ramadan, I. K., Al-Sayes, F. M., & Bahy, K. M. (2016). Hand
hygiene and health care associated infection: an intervention study. Am J Med Med
Sci, 6(1), 8.
Abdulsalam, M., Ibrahim, A., Michael, G., & Mijinyawa, A. (2015). Hand washing practices
and techniques among health professionals in a tertiary hospital in Kano. Journal of
Medical Investigations and Practice, 10(1), 8.
Boyce, J. M. (2011). Measuring healthcare worker hand hygiene activity: current practices
and emerging technologies. Infection Control & Hospital Epidemiology, 32(10),
1016-1028.
Bukhari, S. Z., Hussain, W. M., Banjar, A., Almaimani, W. H., Karima, T. M., & Fatani, M.
I. (2011). Hand hygiene compliance rate among healthcare professionals. Saudi Med
J, 32(5), 515-9.
Eiamsitrakoon, T., Apisarnthanarak, A., Nuallaong, W., Khawcharoenporn, T., & Mundy, L.
M. (2013). Hand hygiene behavior: translating behavioral research into infection
control practice. Infection Control & Hospital Epidemiology, 34(11), 1137-1145.
Lebovic, G., Siddiqui, N. & Muller, M.P. (2013) Predictors of hand hygiene compliance in
the era of alcohol-based hand rinse. Journal of Hospital Infection, 83(4), 276-283.

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McGuckin, M., & Govednik, J. (2013). Patient empowerment and hand hygiene, 1997–
2012. Journal of Hospital Infection, 84(3), 191-199.
Randle, J., Firth, J., & Vaughan, N. (2013). An observational study of hand hygiene
compliance in paediatric wards. Journal of clinical nursing, 22(17-18), 2586-2592.
Scheithauer, S., & Lemmen, S. W. (2013). How can compliance with hand hygiene be
improved in specialized areas of a university hospital?. Journal of Hospital
Infection, 83, S17-S22.
Souza, L. M. D., Ramos, M. F., Becker, E. S. D. S., Meirelles, L. C. D. S., & Monteiro, S. A.
O. (2015). Adherence to the five moments for hand hygiene among intensive care
professionals. Revista gaucha de enfermagem, 36(4), 21-28.
Stahmeyer, J. T., Lutze, B., Von, Lengerke, T., Chaberny, I. F., & Krauth, C. (2017). Hand
hygiene in intensive care units: a matter of time?. Journal of Hospital Infection, 95(4),
338-343.
Tejada, C. J., & Bearman, G. (2015). Hand hygiene compliance monitoring: the state of the
art. Current infectious disease reports, 17(4), 16.