Improving Hand Washing Compliance

Patients have observed several physicians and nurses not washing their hands before interacting with patients. Hand hygiene is one of the largest tactics to combat nosocomial infections. The hospital should adopt a culture of 100% compliance with hand washing. The first step would be to increase handwashing stations and have more quick-dry alcohol-based antibacterial soap dispensers. Making access easier and decreasing the time taken to wash one’s hands would encourage adherence the policy. Furthermore, each floor should track hand washing and report data of potential nosocomial infections caused by improper handwashing. Keeping patients protected from bacteria is important especially when most are in an immunocompromised

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CDCs clean hands count campaign aim to improve healthcare provide adherence to hand hygiene recommendations, address, myths and misperceptions about hand hygiene and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands and the most germs that cause serious infections in healthcare are spread by people’s action, every patient is at risk of getting an infection while they are being treated for something else, hand hygiene is a great way to prevent infections and healthcare providers clean their hands less than half of the time they should, good hand washing is the first line of defense against the spread of many illness.

Generations of people have considered handwashing a measure of personal hygiene. In 1847, Dr. Semmelweis insisted that healthcare providers wash their hands with disinfecting agents between patients. This early hand hygiene practice resulted in a decrease in mortality rates among hospital patients (CDC, 2002). The CDC’s Healthcare Infection Control Practices Advisory Committee published the Guideline for Hand Hygiene in Health-Care Settings in 2002 that is based on hand hygiene foundations developed in generation past. In 2014, this guideline is still available online and used as a reference

This study was intended to prove that hand hygiene practiced according to the CDC guidelines will decrease the incidence of hospital acquired infections. This could not really be proved in this study since the hospitals were not able to maintain improvement in hand hygiene. Health care workers were familiar with guidelines but significant practice changes were not maintained. Some of the infection rates did improve during this time but the correlation with hand hygiene is not consistent. There were other practice changes occurring during this same time and those changes may be responsible for the decreased infection rates.

There are numerous evidence-based practice interventions that have become standard nursing practices across the country. Hand hygiene is a nursing practice intervention that is currently evidence (research) based. It is one of, if not the most, important interventions practiced in providing standardized care. The rationale behind that statement refers to the high percentage of hospital acquired infections; hand hygiene practices are measures used for maximum effectiveness in reducing the spread of these infections. Compared to the various health care professionals who come in contact with patients when providing care, nurses are by far the largest faction that implements the highest quantity of direct patient care in health care. That said, of all the asepsis precautions, techniques, and interventions that are currently in place, hand hygiene is the single most effective intervention used by nurse to prevent themselves from infection and the cross-infection to their patients. Although this evidence-based intervention is of utmost importance to implement at all times, research shows the difficulty in influencing nurses and other health care professionals to practice hand hygiene as often as recommended.

Keeping our hands clean is one of the most effcient and important steps we can do as humans to avoid getting sick or spreading germs to other people. Unwashed hands spread many diseases such as the flue, E. coli, and salmonella. Unfortunately, hand hygiene is still one of today’s most leading causes of infection in health care facilities. The risk of clinicians, patients, and visitors not complying with hand hygiene protocols creates a practice problem for nurses and their patient care. The cause of health care infections, also known as, health care-associated infections (HAIs) are increasing along with the rise of the inability to control or treat infections that are multi-drug resistant. Lack of proper hand hygiene is a major problem in clinical settings sourcing from critical care divisions where the most contaminations are prevalent. This paper will discuss how hand hygiene affects the nursing process and solutions of how to better prevent HAIs within the nursing scope of practice.

Hospital acquired infections (HAIs) affect over 1.7 million patients each year, causing almost 100,000 deaths annually in the United States alone (Johnson, 2010). According to the World Health Organization, HAIs are the most frequent adverse event in the healthcare industry. Fortunately, most of these infections can be prevented with one single intervention, proper hand hygiene (“The Evidence,” n.d.). Four out of five pathogens that cause illness are spread by direct contact. Proper hand hygiene eliminates these pathogens and helps to prevent cross-contamination and HAIs (Linton, 2015; “Hand Hygiene,” n.d.). Reduction of cross-contamination and HAIs improves patient outcomes, increases employee wellness, and lowers health care costs. Adherence to proper hand hygiene is the single most important safety measure in the health care setting. However, for many years compliance to proper hand hygiene in the healthcare industry has been dismally low. New and inventive measures must be implemented to increase compliance to proper hand hygiene and lower the rate of hospital-acquired infections.

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(McCaughey, 2016). The Center of Disease Control recommends hand washing with vigorous scrubbing for at least 15 seconds with soap and water. Using alcohol based gel hand sanitizer can be an appropriate alternative if soap and water is not readily available but does possess drawbacks including being ineffective against alcohol resistant bacteria. Programs for surveillance have also been implemented in hospitals with the intention of monitoring staff to ensure that policies are being followed to ensure the safety of the patients. Mandated reporting of hospital-specific rates and statistics for healthcare-associated infections has the potential to serve a purpose that could result in bringing down the instance for infection. Being forced to announce to the public infections rates versus other healthcare organizations has the potential for higher administration to implement better policies to assure their good standing in the eye of the

Prevention strategies of nosocomial infections related to poor hand hygiene include revision of: orientation, training processes, competency assessments, equipment cleaning, handwashing procedures, switching to the use of single-use IV flush vials, adding strategically located waterless hand rubs, defining supervisory expectations, conducting in-services, team trainings, and tracking systems (Infection control related sentinel events, 2003). Potential solutions to noncompliance include: consistent skin protectant application, reduced time required for handwashing, and antiseptic stations at the bedside and room entry points (Boyce, 1999). Hospital administrators must create an organizational atmosphere in which adherence to recommended HH practices are considered an integral part of providing high-quality care (Boyce, 1999). Improvement in infection control

Healthcare associated infections have an impact on patients - how? Can be prevented greatly with compliance to hand hygiene protocols (REF).

The solution to increasing hand-washing compliance does not have a simple, one fix-all answer. Instead, there are a few small ways that can contribute to increasing our hand-washing compliance. Some LHSC locations have made significant progress in compliance rates however, there is still room to improve towards the goal of 100 per cent compliance. Figure 1 provides a graphical representation of the average hand-washing compliance rates for moments 1 and 4 in relation to LHSC’s goal. The compliance rates displayed are shown as an average for the University Hospital and Victoria Hospital.

Hand hygiene practices are important thing to infection prevention and control practice. As health provider especially ED staff or front liner, to follow hand washing protocols is necessary in any situation. According Practice Standard (2009) four major elements to preventing practice; hand washing, protective barriers, care of equipment and health practice of nurse. Cite from Health Promotion Agency for Northern Ireland, scientists has found around 45% of infections can be prevented by washing hands regularly. MOH (2010) increasing in hand-washing compliance by

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