University Nursing Capstone: Hand Hygiene Practice Proposal

This nursing capstone project proposal addresses the critical issue of poor hand hygiene among healthcare workers, specifically in settings like home health and skilled nursing facilities. The proposal highlights the prevalence of inadequate hand washing techniques and the need for improved practices, citing evidence from various studies that reveal a gap between knowledge and actual hand hygiene compliance. The project emphasizes the negative impact of poor hand hygiene on patient health, care staff, and healthcare costs, with a focus on reducing healthcare-associated infections (HCAIs). The proposed solution involves implementing effective training programs and environmental changes to promote adherence to WHO hand hygiene guidelines. The significance of the project is underscored by its potential to reduce HCAIs, improve patient outcomes, and optimize healthcare expenditure. The proposal includes a detailed description of the problem, its context, impact, and significance, along with references to relevant research and literature.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

1NURSING
Research problem:
This research proposal focuses on the research problem of poor hand hygiene or poor
hand washing technique among health care workers.
The setting or context of the problem:
The problem of poor compliance to hand washing is mostly prevalent in health care
setting. This research proposal aims to examine hand washing practices at home health and
hospices skilled nursing care services and identify adherence to adequate technique of hand
washing (Gould et al., 2017). The service consists of 40 caregivers including nurses, CNA,
LVNs and health care assistants and research will identify the need for improving hand washing
practices among these caregivers.
Details of the research problem:
The context of hand washing practices among health care professionals needs urgent
attention because of presence of various evidence regarding poor knowledge and practices
related to hand washing among health care workers. By conducting an institution based cross-
sectional survey regarding hand washing practices and knowledge among health care
professionals in an hospital, the study by Jemal (2018) revealed that majority of respondents
has knowledge about hand washing. However, the poor practices in relation to hand washing was
highly prevalent. Another study evaluating hand washing practices among nursing students
revealed that adherence to hand hygiene guideline is very low among health care workers and
most of the health care workers do not assume hand hygiene to be important during different
clinical situations (Mahmood, Verma & Khan, 2017). These evidences further confirms that
there is a need to increase knowledge and skills related to good hand washing practices to lower

2NURSING
the rate of health care associated infection (HCAIs). It gives implication for further research and
change in current training programs too.
Impact of the problem:
Poor compliance to good hand washing practices can have negative impact on health of
patients as well as care staffs and it can also increase the overall cost associated with care.
Firstly, hand washing or hand hygiene is a step that direct prevents transmission of infection
from one place to another. However, when appropriate hand washing process is not followed,
this leads to the increase in risk of HCAIs. Di et al. (2015) shows the direct link between hand
hygiene and likelihood of nosocomial infection. For this reason, hand hygiene is often targeted in
hospitals aiming to reduce the risk of health care associated infections.
Significance of the problem:
The significance of the research problem is understood from its impact on health of
patient and care workers and overall impact on health care expenditure. Nurses working in
clinical setting are most likely to contaminate their hands during patient assessment and other
activities and their hands act as vehicle for transmission of health care associated pathogens.
However, the simple task of hand hygiene at the right time works to reduce the rate of HCAIs
(Awoke et al., 2018). For this reason, paying attention to the practice of hand washing is
important to reduce rate of HCAIs and reducing unnecessary health care cost due to such issues.
A proposed solution to the identified topic:
As literature review on the problem of poor hand washing shows poor compliance to
good hand hygiene practices, the proposed solution is to implement effective training programs

3NURSING
and environmental changes in health care setting so that they are aware about the WHO hand
hygiene guidelines and are adequately reminded about hand washing at critical situations where
infection can be easily transmitted (Cruz & Bashtawi, 2016).

4NURSING
References:
Awoke, N., Geda, B., Arba, A., Tekalign, T., & Paulos, K. (2018). Nurses Practice of Hand
Hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern
Ethiopia: Observational Study. Nursing research and practice, 2018.
Cruz, J. P., & Bashtawi, M. A. (2016). Predictors of hand hygiene practice among Saudi nursing
students: A cross-sectional self-reported study. Journal of infection and public
health, 9(4), 485-493.
Di, M. M., Cammilletti, V., Petrelli, E., & Di, E. S. (2015). Hand hygiene in preventing
nosocomial infections: a nursing research. Annali di igiene: medicina preventiva e di
comunita, 27(2), 485-491.
Gould, D. J., Creedon, S., Jeanes, A., Drey, N. S., Chudleigh, J., & Moralejo, D. (2017). Impact
of observing hand hygiene in practice and research: a methodological
reconsideration. Journal of hospital infection, 95(2), 169-174.
Jemal, S. (2018). Knowledge and Practices of Hand Washing among Health Professionals in
Dubti Referral Hospital, Dubti, Afar, Northeast Ethiopia. Advances in preventive
medicine, 2018.
Mahmood, S. E., Verma, R., & Khan, M. B. (2017). Hand hygiene practices among nursing
students: importance of improving current training programs. International Journal of
Community Medicine and Public Health, 2(4), 466-471.