The Benefits of Hand Hygiene in Nursing Care: A Research Report

This report delves into the critical role of hand hygiene in nursing, emphasizing its benefits for infection control and patient safety. The study explores the impact of improper hand hygiene leading to contagious infections, and aims to identify elements enhancing hand hygiene practices, like sanitization using alcohol-based sanitizers or soap and water. The research addresses the problem of multi-resistant bacteria contributing to nosocomial infections and poses a PICOT question regarding the effectiveness of alcohol-based hand sanitizer versus soap and water. The report reviews studies highlighting the importance of hand hygiene in reducing nosocomial infections, and discusses ethical considerations in hand hygiene implementation, emphasizing the need for culturally sensitive practices and patient safety. The report concludes that hand hygiene is essential for preventing hospital-acquired infections, offering practical strategies and stressing the ethical importance of prioritizing patient safety in nursing practice.

Running head: HAND HYGIENE
Benefits of Hand Hygiene in Nursing Care
Name of the Student:
Name of the University:
Author Note:

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Evidence of Revision
The study of the articles highlight cause of infections due to improper hand hygiene.
Maintenance of proper hand hygiene had always played a key role in elimination of
infections thus always remained a primary mode of precaution towards elimination of
infections. It has been evident that how improper hand hygiene can lead to contagious
infections as well can also contribute towards worsening the conditions of the patients .
The research has been carried out in order to identify the element that can put greater
impact towards the implementation of hand hygiene. The elements taken into consideration,
which can act towards enhancement of hand hygiene, are; sanitization-using alcohol based
sanitizers or soap and water controlled sanitization (Gould et al., 2017).
The most important outcome of the study was aimed towards understanding that what
measures can be taken or what measures can be much suitable towards eradication of
Nosocomial Infection or Cross Infection during the stay of a patient. The article states the
studies and implementation of hand hygiene in the nursing practice and also discusses how its
implementation can benefit the healthcare society.
Nursing Practice Problem and PICOT Question
Multi-resistant bacteria has contributed towards the cause of nosocomial infections.
The atmosphere of nursing homes differs majorly from the settings of other well established
healthcare entities it terms of service providing, sanitization, quality treatment and attitude
towards improvement of hand hygiene. The information providing and education providing
lacks in several healthcare field which have been stated as the cause towards the failure in
implementation of proper sanitization in several healthcare field (Hammerschmidt, &
Manser., 2019).

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PICOT Question: In patients admitted in hospital how effective is alcohol based hand
sanitizer compared to soap and water in controlling Nosocomial Infection or Cross Infection
during the length of stay.
P (patient or population) - patients admitted in the hospitals
I (Intervention) - Hand sanitizer
C (Comparison) - Soap and Water and Alcohol based Sanitization
O (Outcome) - Nosocomial infection or Cross infection
T (Time) - Length of stay
Patient admitted in the healthcare entity are the focus of care and should be provided
with interventions with proper measures for the betterment of their health.
Intervention through hand sanitizer can be a mechanism towards the cure, which can
help via keeping the undesired elements disrupting the procedure towards health providing.
Comparison was mentioned in terms of usage of hand sanitizations either based on the
use of alcohol based hand sanitizers or based on sanitization using soap and water.
Outcome aimed through the said procedures are to find an intervention towards
finding the best element for the implementation in the sanitary care of hand hygiene, which
may help in reduction of spread of infections.
Time state the phase, when the implementation is necessary to reduce the impact of
infection and implement high quality infection control.
Background of Studies
The maintenance of hand hygiene by the nurses had been one of the primary
mechanisms in reducing Nosocomial Infections. In order to promote the application of hand

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hygiene, an implementation of Global Hand washing Day on 15th October have been settled
up to create awareness of safety by proper hand Hygiene (ncass.org.uk, 2020).
A common and highly transmissible skin disease impetigo, have been noticed among
the children due to improper hand hygiene which have shown immense impact by production
of blisters and sores that have efficiently eroded the skin. The treatment of such requires
proper hand hygiene to be implemented in order to reduce the transmission of the disease
(ncass.org.uk, 2020).
Flu had been another such examples, which have shown catastrophic effects by
causing immense fatigue, coughing and headaches. The disease has shown to effect by
transmission through coming in contact with contaminated surface. Other such spread shows
infection by Campylobacter and Salmonellosis. Due to improper hand hygiene, it have been
evident that contamination of food have majorly took place, which have resulted in nausea,
vomiting and diarrhea (ncass.org.uk, 2020).
The concept of hand washing in patient care have been introduced in 19th century. The
first evidence of beneficial hand hygiene in patient care have been introduced by reducing the
puerperal fever and mortality among the mothers in maternity ward. The study shown that
when medical students in a hospital with two maternity ward arrived among one of them
directly from the autopsy room after treating and studying puerperal fever , it had shown a 10
percent rate of maternal mortality. While, when the midwives have controlled the other clinic
it had a low maternal mortality rate of 2 percent.
Moreover, a research has stated that Middle East respiratory syndrome coronavirus
(MERS-CoV) has been identified lethal with a rate of 35.7 percent deaths. The study stated a
death of 779 individuals among 2182 cases across 27 countries. The study also stated
interventions that are possible which included preventing the nosocomial transmission using

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proper hand hygiene. Thus, the study states that how important can be the implementation of
hand hygiene can be in preventing the infection transmission (Hui et al., 2018).
Method of Studies
An article reviewed a cross sectional study conducted among 200 nurses out of 240
nurses; among three hospitals in the Kerman City of Iran. The selected participants were
having a minimum experience of three years of practice as a health care professional (Sharif
et al., 2016).
For data gathering the study questionnaire has been used. There were two segments in
this questionnaire. The first part: age, gender, education, work background and sector type
demographics. There are three parts in the second section. In the first part, participants '
awareness on hand hygiene was assessed based on 10 responses. They replied to them yes
and no. The no-response value is zero and the 1-point is an answer yes. The assessment
technique for the variable of understanding was 0-4 (low), 4-7 (average) and 7-10 for high-
level assessment. The second part consisted of 10 sections in which the questions were
replied with the Likert five-point (firmly in Strongly Agree (5), Agree (4), no declaration (3),
disagree (2) and Strongly Disagree (1)). The second part deals with the determination of the
behaviour of care-givers in hand sanitary issues. The score (10-23) was judged to be low,
score (24-36) to be pooled and score (37-50) to be high. In the final part, the five-point Likert
was challenged to respond in ten parts (Strongly Agree (5), Agree (4), no declaration (3),
disagree (2) and Strongly Disagree (1)). The questions were answered in five stages. The
final part addresses the actions of health care providers in the presence of healthcare
professionals. The result was 10-23, and the score was low (24-36) and high (37-50) (Sharif
et al., 2016).

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Ethical Considerations
Hand hygiene involves ethical considerations that need to be followed by
healthcare settings on a global basis. The failure of complying with the organisational hand
hygiene guidelines is stated to be an ethical issue. The mortality rate due to this issue is
significant and can be reduced by using straightforward and cheap practices (Bernard et al.,
2018). However, the staff does not abide by the standards resulting in not meeting the targets.
Proper hand hygiene needs to be focused that require morally appropriate choices that are
consistent with the virtues of competent nursing professionals. The primary obligation of
nursing practitioners is to offer a safe and effective provision of care by abiding the ethical
standards and principles of nursing (Sadule-Rios & Aguilera, 2017). It is essential the
practice of hand hygiene is directly correlated to a culture of patient safety and needs to be
incorporated within the pre-defined parameter of safe practice. It is critical that the choice of
practice involving appropriate and accurate hand hygiene demonstrates respect and care to
the patient. (Marques et al., 2017) opined that the cultural diversity of patient is one of the
major ethical concerns that is reported in numerous studies and cause a moral dilemma for
the nurses. Therefore, the provision of hand hygiene of patients’ needs to be done aligned
with the cultural belief, values, and thought of the patient and offering a comprehensive care
approach with respect to hand washing. The nurses have to avoid any harm to patients and
practicing proper hand hygiene measures. The provision of hand washing is associated with
professional judgment and need to be reasonable in nature that states that in some case, it can
be avoided. The outcome of washing hands or failing to do so can be weighed and may result
in a Hospital Care-Associated Infection (HCAI). Thus, care need to be taken while
considering the aspect and ensuring justification that priorities patient safety and efficacy.

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Conclusion
It can be concluded by stating that hand hygiene is an essential measure that
helps in avoiding the chance of acquiring infection in hospitals by limiting the transmission
of germs. There are a number of practical and straightforward strategies that can be applied in
this case in the present scenario of the growing stress of HCAI in hospitals. On an ethical
ground, it can be stated that it is a vital practice in the nursing context; however, in some
situations, it can be avoided as per to ensure priority to patient safety.

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References
Bernard, L., Biron, A., Lavigne, G., Frechette, J., Bernard, A., Mitchell, J., & Lavoie‐
Tremblay, M. (2018). An exploratory study of safety culture, biological risk
management and hand hygiene of healthcare professionals. Journal of advanced
nursing, 74(4), 827-837.
Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions
to improve hand hygiene compliance in patient care. Cochrane database of systematic
reviews, (9).
Hammerschmidt, J., & Manser, T. (2019). Nurses’ knowledge, behaviour and compliance
concerning hand hygiene in nursing homes: a cross-sectional mixed-methods
study. BMC health services research, 19(1), 547.
Hui, D., Azhar, E., Kim, Y., Memish, Z., Oh, M., & Zumla, A. (2018). Middle East
respiratory syndrome coronavirus: risk factors and determinants of primary,
household, and nosocomial transmission. The Lancet Infectious Diseases, 18(8),
e217-e227. doi: 10.1016/s1473-3099(18)30127-0
Marques, R., Gregório, J., Pinheiro, F., Póvoa, P., Da Silva, M. M., & Lapão, L. V. (2017).
How can information systems provide support to nurses’ hand hygiene performance?
Using gamification and indoor location to improve hand hygiene awareness and
reduce hospital infections. BMC medical informatics and decision making, 17(1), 15.
ncass.org.uk. (2020). Consequences of poor hand hygiene. Retrieved 2 February 2020, from
https://www.ncass.org.uk/mobile-catering-home/articles/consequences-of-poor-hand-hygiene
Sadule-Rios, N., & Aguilera, G. (2017). Nurses’ perceptions of reasons for persistent low
rates in hand hygiene compliance. Intensive and critical care nursing, 42, 17-21.

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Sharif, A., Arbabisarjou, A., Balouchi, A., Ahmadidarrehsima, S., & Kashani, H. H. (2016).
Knowledge, Attitude, and Performance of Nurses toward Hand Hygiene in
Hospitals. Global journal of health science, 8(8), 53081. doi:10.5539/gjhs.v8n8p57