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Is proper hand hygiene in the hospital setting
Chapter 4, Evidence-Based Practice
Is proper hand hygiene in the hospital setting
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Examine the ways that health professionals can use five steps of evidence based practice (EBP) as a practical framework to overcoming barriers to locating, appraising, and applying the best research evidence to an occupational health and safety practice.
- Infection control: Hand washing
Are interventions to promote hand hygiene an effective measure in reducing hospital-acquired infections?
One of the most significant current discussions in nursing evidence-based practice is the effectiveness of hand hygiene interventions in reducing hospital-acquired infections. Much debate continues into the uncertainty that exists between the correlation of interventions and increased hand hygiene practices. This essay critically examines the relationship between interventions and the dubious increase in hand hygiene compliance by healthcare professionals by using the framework of evidence based practice to evaluate previous literature, identify barriers and note mechanisms used to measure effectiveness of interventions.
The systematic review; Interventions to improve hand hygiene compliance in patient care, conducted by the Cochrane Collaboration investigated inventions to improve hand hygiene compliance within patient care. The review included 2 original studies with an additional two new studies (Gould & Moralejo et al., 2010). Throughout the review it was affirmed that among hand hygiene is an indispensable method in the prevention of hospital-acquired infections (HAI), the compliance among nurses’ is inadequate. Nurses are identified within the public as dependable and trustworthy in a time of vulnerability due to their specialised education and skills (Hughes, 2008). Thus, it is imperative that evidence based practice is cond...
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...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Stout, A., Ritchie, K. & Macpherson, K. (2007). Clinical effectiveness of alcohol-based products in increasing hand hygiene compliance and reducing infection rates: a systematic review. Journal Of Hospital Infection, 66 (4), pp. 308--312.
Whitby, M., Pessoa-Silva, C., Mclaws, M., Allegranzi, B., Sax, H., Larson, E., Seto, W., Donaldson, L. & Pittet, D. (2007). Behavioural considerations for hand hygiene practices: the basic building blocks. Journal Of Hospital Infection, 65 (1), pp. 1--8.
Liamputtong, P. (2013). Research methods in health. 2nd ed. South Melbourne: Oxford.
Harkness, G. A. & Demarco, R. (2012). Community and public health nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Health tips. Hand hygiene. (2009). Mayo Clinic Health Letter (English Ed.), 27(12), 3. Retrieved from
Scott II, D. R. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
This literature review will analyze and critically explore four studies that have been conducted on hand hygiene compliance rates by Healthcare workers (HCWs). Firstly, it will look at compliance rates for HCWs in the intensive care units (ICU) and then explore the different factors that contribute to low hand hygiene compliance. Hospital Acquired infections (HAI) or Nosocomial Infections appear worldwide, affecting both developed and poor countries. HAIs represent a major source of morbidity and mortality, especially for patients in the ICU (Hugonnet, Perneger, & Pittet, 2002). Hand hygiene can be defined as any method that destroys or removes microorganisms on hands (Centers for Disease Control and Prevention, 2009). According to the World Health Organization (2002), a HAI can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. The hands of HCWs transmit majority of the endemic infections. As
Numerous studies have reported that hand hygiene reduces health care associated infection rates. Compliance to proper hand hygiene guidelines continues to be low among health care workers. To improve hand hygiene performance and have continued compliance over time, the need to find out what the barriers are need to be sought out. These may include poor access to hand hygiene information, skin irritation, forgetfulness, time constraints, a perception that hand hygiene interferes with worker-patient relationships, lack of knowledge of hand hygiene guidelines, and poor habits learned early in life (KuKanich, Kaur, Freeman, & Powell, 2013, p.
“Failure to attend to hand hygiene has serious consequences: it has a negative effect on patient safety and the quality of patients’ lives, as well as on their confidence in healthcare delivery. However, the prevalence of hand hygiene omission is still high” (Canadian Disease Control, 2016 p 1). Washing hands before and after patient contact seems like a simple solution to prevent the spread of bacteria between patients. But it is not as simple as it seems.According to new CDC data, “approximately one in 25 patients acquires a health care-associated infection during their hospital care, adding up to about 722,000 infections a year. Of these, 75,000 patients die from their infections ( CDC, 2016 p 1).” Leaving a finacial burden on Canada’s health care
...f infections acquired during the hospital. Many of these studies have indicated that these infection control interventions will decrease the number of sick or dying patients related to hospital acquired infections and lower the medical cost by decreasing the stay of each patient in the hospital.
Therefore, implementing evidence-based knowledge focused on arriving at positive goals for better patient outcomes should be a priority. Additionally, if nurses are to decrease the incidences of central-line infections, then hospitals need to be focused on prevention through clinical reasoning and preventive action. It is the responsibility of nursing care to provide the best care possible and to follow infection control standards.
Significance: The topic of Hospital Acquired Infections (HAIs) is important for all healthcare worker to understand the care they provide to patients can be directly associated with these infections. Healthcare workers must realize the impact these unexpected infections have on a patient’s health and financial wellbeing.
What are the best ways of achieving this in the reality of the modern NHS? To conclude, Evidence Based Practice is a process of building up accurate information from medical research which has been correlated and assessed. From this, the nurse is capable of advising the best plan of care. For nursing standards to improve, it is vitally important that the nurse is given the time to research and the trust to start off the process of change for better care. References Cullum, N., Ciliska, D. and R. Haynes, Marks (2008).
Medical asepsis plays an integral role in infection control within a health care facility. It includes procedures used to decrease and prevent direct contact with blood or bodily fluids and emphasizes keeping the environment clean on a regular basis (Curchoe, Astle, & Hobbs, 2014). In order to achieve optimal health, individuals depend on practices and techniques that control and ultimately prevent the transmission of infection. These practices and techniques can help avoid the transmission of infections by creating an environment that protects both health care workers and patients from communicable diseases. Good hand hygiene has been stressed as the single most important measure to prevent cross-infection to patients in health care facilities
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
Nies, M. A., & McEwen, M. (2011). Community/public health nursing: Promoting the health of populations (5th ed.). St.Louis, MO: Saunders.
“Researchers in London estimate that if everyone routinely washed their hands, a million deaths a year could be prevented” (“Hygiene Fast Facts”, 2013, p. 1). Hands are the number one mode of transmission of pathogens. Hands are also vital in patient interaction, and therefore should be kept clean to protect the safety of patients and the person caring for the patient. Hand hygiene is imperative to professional nursing practice because it prevents the spread of pathogens, decreases chances of hospital-acquired infections, and promotes patient safety. There is a substantial amount of evidence that shows why hand hygiene is important in healthcare
The Infection Prevention and Control (IPC) Program is an essential force maximizing quality, patient centered care, and safety throughout the Veterans Affairs North Texas Health Care System (VANTHCS). The VANTHCS “... is a progressive health care provider in the heart of Texas ... we serve more than 117,000 Veterans and deliver 1.4 million outpatient episodes of care each year to Veterans in 38 Texas counties and two counties in southern Oklahoma” (“VA North Texas,” 2016, para. 1). The purpose of the IPC Program is to guide a facility-wide approach toward identifying, preventing, controlling, and eliminating healthcare-associated infections (HAIs). This approach is facilitated through infection control (IC) practitioner’s role-modeling behaviors of assessing, supporting, guiding, and/or directing healthcare providers (HCPs) in the application of evidence-based practices (EBPs) to prevent HAIs. According to the Centers for Disease Control and Prevention (CDC), HAIs are often preventable adverse events that pose a major threat to patient safety (“Centers for Disease,” 2016). As a result, IC practitioners recognize the importance of preparing nurse faculty to engage clinical staff in the application of EBPs to prevent infections.
Nies, M. A., & McEwen, M. (2011). Community/public health nursing: Promoting the health of populations (5th ed.). St.Louis, MO: Saunders.