Hand Hygiene

Hand Hygiene

            Research on hand-washing hygiene is a contentious issue in the healthcare sector. Healthcare-related infections have been drawing increased attention among healthcare workers, patients, government, and insurance companies, raising concern on the role played by hand hygiene in such cases. The concern on hand hygiene is not only raised because of the associated impacts such as mortality and increased costs of management but also because most of the complications are preventable if hygiene is considered. Most infections are transmitted when health care workers attend to patients with contaminated hands and also risk being infected. Also, infections may be transmitted from the patients to the healthcare workers, or from a patient to another patient due to poor hygiene. The issue of hand hygiene creates controversy in that the level of hygiene is an issue of concern because not clear guidelines are set on the level of hygiene that should be maintained. Poor hand hygiene is responsible for several infections acquired from the healthcare facilities and should be improved to avoid cases of infections that would be prevented.

Significance of Hand Hygiene

Patients visit or are taken to the healthcare facilities for treatment or other healthcare services. Health care facilities are expected to maintain a high level of hygiene to avoid exposing patients and workers to diseases. Generally, health care facilities should be a source of healing and not an illness, as has been the case in recent years. Also, health care facilities have a higher risk of spreading diseases when hygiene is poorly maintained. For example, disease-causing agents from patients are highly concentrated at the health care facilities, and one could easily acquire an infection if care is not taken. Besides, health care workers attend to several patients and should be careful to avoid passing infections from one patient to another. Therefore, the issue of hand hygiene is essential in managing disease control strategies and should be taken seriously by the health care facility workers, patients, and other responsible authorities such as the government.

Current Healthcare Practices impacting Hand Hygiene

Healthcare management is hierarchical. Generally, the people at the low levels of practice look for the conduct of their seniors and follow their footsteps. However, most senior officers have not been taking the hand hygiene issue seriously. Therefore, weak policies have been allowed to exist at the expense of suffering patients. Also, sensitization has not been done sufficiently to curb the rampant cases of poor hygiene at the healthcare facilities. Currently, senior officers are being sensitized to improve their impact over their subordinates concerning the need for high hygiene. Also, the government is coming up with strategies to improve sensitization among the relevant parties.

Impact of Poor Hand Hygiene on the HealthCare Sector and Patients’ Cultural Background

The trust of patients in a healthcare facility is always based on the safety and quality of services obtained. The issue of poor hand hygiene and the spread of diseases has come to destroy the trust that has been held by patients towards the healthcare facilities. Also, the healthcare facilities have been losing confidence in their ability to deliver quality services towards the patients. The culture of a healthy relationship between patients and healthcare facilities has changed to involve fear and precaution for fear of associated risks.

Literature Review

Nurses are always in the middle of the hand hygiene crisis. The nurses always have the highest interaction rate with patients compared to other healthcare workers. Hand-washing is therefore encouraged among nurses to address the issue of diseases being spread due to poor hand hygiene. According to Fox et al. (2015), using a patient hygiene protocol improves the nurses’ hand-washing motivation. Generally, hand hygiene requires collaboration between various bodies involved in the crisis. Murni et al. (2015) found out that better hand hygiene would reduce the spread of diseases among patients and other healthcare workers. Besides, the attempts to improve hand hygiene are supported by the government and insurance companies that have been incurring high costs while attempting to address the issues associated with poor hand hygiene.

Hand hygiene compliance among healthcare workers is a headache for healthcare management. Workers appear to overlook the impacts of poor hand hygiene in healthcare centers. According to Mu et al. (2016), compliance among healthcare workers needs intervention to instill a feeling of responsibility. The researchers carried out a research in China and recommended that interventions are needed to address the growing number of diseases spread among patients in healthcare centers. Also, the study shows similar findings to the one done by Patel et al. (2016) to assess the impact of a multifaceted intervention towards improving hand hygiene compliance among healthcare workers. Generally, hand hygiene cannot be implemented with the cooperation of the various authorities. According to King et al. (2016), hand hygiene

compliance should be given prime attention in healthcare centers. Also, healthcare workers should be introduced to efficient hand hygiene practices.

Research by Mathur (2014) showed that hand hygiene was among the basic measures of disease control. Therefore, compliance should be improved among healthcare workers to ensure that diseases are no longer acquired from the healthcare centers. Kampf, Löffler, and Gastmeier (2019) narrowed the research to accommodate nosocomial infections. The severity of the association between hand hygiene and the spread of diseases calls for interventions that should involve all the relevant authorities.

Research Evidence

Jones, Martello, Biron and Lavoie‐Tremblay did a research in 2017 to identify the interventions that improve hand hygiene compliance (HHC) specifically among nurses. The researchers carried out twelve studies to assess the impact of education on compliance. After a successful research, the researchers concluded that education improved compliance among nurses although the compliance dropped after one month. The research was similar to another research carried out by Quilab, Johnson and Schadt in 2019 to check whether education improved compliance among the nurses in a health facility. The study was based on a sample of one hundred and twenty participants and showed significant positive impacts of education on compliance.

In the year 2016, Brian Zimmerman published an article on the four common interventions that improve hand hygiene among healthcare workers. According to Zimmerman, hand hygiene can only be improved if healthcare workers are involved in decision making. Also, another research was done by Mathur (2014) and showed that hand hygiene was among the basic measures of disease control. Therefore, compliance should be improved among healthcare workers to ensure that diseases are no longer acquired from the healthcare centers.

PICO

The patients are the central consideration in the hand hygiene issue. Generally, the healthcare facilities aim at offering the highest possible quality of services to the patients. The spread of diseases is, therefore, a set back towards the move to ensure that the patients are treated as they would expect. The articles considered for the research present a wide consideration of the interests of the patients. For example, the research by Fox et al. (2015) involved assessing the rate of patient infection in the healthcare facilities and the efforts done to see that patients no longer suffered from preventable conditions.

The intervention measures include the efforts put into improving the compliance of healthcare workers towards hand hygiene. The articles considered have proposed several interventions towards dealing with the hand hygiene challenge. However, the main intervention proposed by the articles is hand-washing. Mathur (2014) proposes hand washing as a measure of preventing the spread of diseases. Generally, Mathur presents hand hygiene as one of the primary measures of avoiding the spread of diseases in healthcare facilities. Generally, hand hygiene calls for hand-washing as an intervention method.

Moreover, the articles pay attention to the use of comparable intervention measures towards improving hand hygiene. The idea of hand washing has been overlooked by most workers, and another intervention method is required. For example, Murni et al. (2015) recommend that the use of antibiotics should be improved in developing countries. Antibiotics could provide a more effective solution to the hand hygiene crisis, but the cost of administration is a setback that calls for continued use of handwashing as a control strategy.

The outcome for the intervention methods proposed is a general reduction in the cases of spreading of diseases due to poor hygiene. The healthcare facilities will be safer when healthcare workers adhere to the intervention recommendations. Generally, the intervention methods are aimed at reducing the rate of acquiring diseases from healthcare facilities.

Recommendation and Implementation

The healthcare workers are in the middle of the hand hygiene crisis. Therefore, a recommendation is made such that healthcare workers should be taken through a training program to equip them with handwashing skills. The implementation of the training program should involve all the stakeholders in the healthcare facility. Furthermore, the involvement of the healthcare workers and their managers ensures that policies are strong. Some of the key stakeholders who may be essential in the implementation of the recommendation are the top managers, patients, and the government.

The government should play the role of financing the training program while the managers oversee the implementation of the results of the training program. On the other hand, the patients may contribute towards the success of the program be insisting the hygiene of the nurses attending to them. Generally, the effectiveness of the program depends on the involvement of the stakeholders.

Moreover, the risk of encountering barriers exists. For example, healthcare workers may not be willing to go through a training program. Also, the training program may be costly for the facility adding the cost of offering affordable services to the patients. However, strategies are set in place to counter the barriers encountered. First, the training program should be incorporated from the recruitment stage so that every worker is trained before their contract takes effect. Secondly, a renewal of contract terms will work perfectly towards forcing workers to take the training seriously. Also, the management may ensure that the only trained nurses are recruited to cut on the cost of providing training after recruitment. Furthermore, the recommendation is based on the evidence provided in the matrix from most researches that education improves compliance among healthcare workers.

References

Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., … & Bader, M. K.      (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and    improve nurses’ hand washing. American Journal of Critical Care, 24(3), 216-224.

Jones, D., Martello, M., Biron, A., & Lavoie‐Tremblay, M. (2017). A systematic review on the      effectiveness of interventions to improve hand hygiene compliance of nurses in the hospital setting. Journal of Nursing Scholarship, 49(2), 143-152.

Kampf, G., Löffler, H., & Gastmeier, P. (2019). Hand hygiene for the prevention of nosocomial   infections. Deutsches Arzteblatt international, 106(40), 649–655.           doi:10.3238/arztebl.2009.0649

King, D., Vlaev, I., Everett-Thomas, R., Fitzpatrick, M., Darzi, A., & Birnbach, D. J. (2016).        “Priming” hand hygiene compliance in clinical environments. Health Psychology, 35(1),      96.

Mathur P. (2014). Hand hygiene: back to the basics of infection control. The Indian journal of      medical research, 134(5), 611–620. doi:10.4103/0971-5916.90985

Mu, X., Xu, Y., Yang, T., Zhang, J., Wang, C., Liu, W., … & Yang, H. (2016). Improving hand   hygiene compliance among healthcare workers: an intervention study in a Hospital in          Guizhou Province, China. Brazilian Journal of Infectious Diseases, 20(5), 413-418.

Murni, I. K., Duke, T., Kinney, S., Daley, A. J., & Soenarto, Y. (2015). Reducing hospital-           acquired infections and improving the rational use of antibiotics in a developing country:          an effectiveness study. Archives of disease in childhood, 100(5), 454-459.

Patel, B., Engelbrecht, H., McDonald, H., Morris, V., & Smythe, W. (2016). A multifaceted         hospital-wide intervention increases hand hygiene compliance. South African Medical       Journal, 106(4), 335-341.

Quilab, M. T., Johnson, S., & Schadt, C. (2019). The effect of education on improving hand         hygiene compliance among healthcare workers. Hos Pal Med Int Jnl, 3(2), 66-71.

Evidence Matrix