Abstract
Hand washing is a crucial part of the healthcare workers. A significant number of infections are spread through dirty or contaminated hands. The research takes an in depth research at hand hygiene practices of qualified nurses. It determines the number of times that they wash their hands, whether they use the right procedure and even whether they clean their hands as required. To do this, data is collected using a questionnaire, there are ten questions that test various aspects such as hand washing procedure, duration and so on. The answers are then fed into an excel file where they are analyzed. The analysis includes tables and graphs representing the data collected. The results deducted from the information is that nurses are aware of the correct hand washing procedures, however, not all adhere to the right procedure when cleaning their hands. It is recommended that refresher courses are done to ensure that nurses are aware of the right procedure at all times. A suggestion for future study should be one the prevalence of HAIs in a hospital and the impact on patients.
Acknowledgments
I would like to thank everyone who helped in the completion of the research paper. My professor, the nurses who provided the raw data for the research and friends, thank you.
Hand Hygiene Practices of Qualified Nurses. An Exploratory Survey
The risk of developing infections is quite high for patients in nursing homes, long term care facilities and a general healthcare facility setting. Most of the infections are spread through direct contact; this is more via the hands of a caretaker. Over time, it has been viewed that hand hygiene, such as washing hands prior or after touching the patients has been proved to be one of the most effective ways of bringing down infections (Kalata et al., 2013). Gradually, there has been an increase in the use of alcohol-based solvents to wash hands. The solvents are proving to be essential supplements to traditional washing that entails the use of soap and water (Chase & Do, 2012). However, the level of compliance with hand hygiene is still poor. The research explores the hand hygiene practices of a qualified nurse, what they do and what they fail to do in a hospital setting. Recommendations are also given on the how to ensure that nurses adhere to the set practices.
Rationale
Hand hygiene is an essential healthcare practice and the most effective technique to bring down the incidences of healthcare associated infections (HCAIs). It also plays a significant role in bringing down the spread of antimicrobial resistance across all healthcare settings, either the most advanced or a basic care facility. Infections spread by the caregivers have been shown to account for 5-10% of the hospitalized patients in the developed world (ALSofiani et al., 2016; AlOmari, & AlQarny, 2016). The figure is even higher in developing and underdeveloped nations where the number of avoidable infections stands at 20% (ALSofiani et al., 2016). Even though there are several measures that can be used to bring down the rates of infection, hand hygiene is cited as the most important tool to help prevent the transmission of infections. However, it is only 50-70% of healthcare providers that comply with the hygiene recommendations (ALSofiani et al., 2016; Barker et al., 2014).
Background
Historically, hand washing had come a long way before it became a standard procedure. In the mid-1800s, healthcare workers discovered that hospital-acquired diseases were primarily transmitted by healthcare workers (Shinefield, & Ruff, 2018). In 1847, a care officer discovered that maternal deaths were higher in one clinic as compared to the other, 16% as compared to 7% in the other clinic (Shinefield & Ruff, 2018). The 1980s brought about the publishing of the national hygiene guidelines across different nations. 1n 1995, the CDC recommended that an antimicrobial soap or an antiseptic agent be used in hand washing (Chase & Do, 2012; Salama et al., 2013). In 2002, HICPAC guidelines for hand washing were updated; they defined alcohol-based cleaning as the standard method for hand washing in a health care setting.
Literature Review
There exists a link between hand hygiene and infection transmission. In his work, Mathur (2011) depicts the importance of hand hygiene in the prevention of infections. A proper understanding of the microbial plays a significant role in helping curb hand infections (Doron et al., 2011). There are two types of microbes that colonize our hands, the resident flora that is made of microorganisms residing under the superficial cells and the transient flora that resides in the superficial skin layers (Al-Tawfiq et al., 2013; Mathur, 2011). In the basics of infection control, Mathur (2011) depicts that transient microorganism survives on the skin, but they do not multiply. Health care workers (HCWs) acquire them through direct contact with the patient or through the contaminated surfaces. With some of the pathogens likely to survive on surfaces for up to 150 hours, the likelihood that a nurse will collect and transfer them increases.
To control infections, Mathur (2011), states that the skin is a major carrier of infections; however, the risk of contamination is even higher due to the regular shedding off. Hospital beds, gowns, linens and other surfaces in a patients immediate environment increases the chances of pathogens transmission (Al-Tawfiq et al., 2014). Hand carriage of pathogens greatly increases nosocomial infections.
Background
The level of attention being drawn to healthcare associated infections is on the rise. Patients, insurers and even regulatory bodies are seeking the best methods to bring the infection rates down (Doron et al., 2011). The push for this is not only determined by the cost or the high mortality rate, but also by the fact that most of the infections are easily preventable. The medical community is awed by the high number of unprecedented comprehension of the infections. On the other hand, the increase in the drug-resistant infections is a wakeup call to the medical fraternity to perfect on what it does (Allegranz et al., 2013; McGuckin 2013). Since the infections take place at a medical care set up, the role of antimicrobial and infection prevention measures is put to the test. New undisputed evidence suggests that strict adherence hand hygiene greatly reduce the risk of infection and cross-transmission of common infections (Boyce, 2011; Chou, Achan, & Ramachandran, 2012). WHO recently initiated the "clean care is safer care" program that helps foster the patient's safety programs? WHO has been on the forefront pushing the developing countries to create principles that will help in the prevention practices in typical health care set up (Stewardson et al., 2013).
Despite the focus given on the caregivers, patients also have a role in helping reduce the number of transmissions. Currently, hand washing isn't a popular practice as it may be globally preferred. Between 0-34% if the population washes their hands before handling food or after visiting the toilets (Mathur, 2011; Bukhari et al., 2012), the figure is relatively low and various measures have been put in place to help increase the numbers. For instance, UNICEF declared October 15 as the global hand washing day since 2008 (Mathur, 2011; Otter, Yezli, Salkeld, & French, 2013). Various measures have been put in place by the CDC and other regulatory bodies on the basics of hand washing.
Methods and Search Strategy
PICO
The PICO strategy will be used to help increase the comprehension of the research topic. By clarifying the question, the search concepts and the type of study that is being done can easily be explained to a third party. Moreover, a deeper understanding of the question will help bring about more relevant results.
Population, patient, problem Intervention Comparison/control mechanisms Outcome
- What is the question about?
- How to minimize the number of hospitals acquired infections
- What is the problem being handled?
- The high number of hospital-acquired infections but spread by HCWs
- Population being focused on?
- Hospital nurses and health care professionals
- Characteristics of the population
- A weak immune system and making them vulnerable to ailments. Treatment/changes being explored
- Hand* as a measure to lower the number of hospitals acquired infections.
- What factors influence the patient's prognosis?
- The hospital and the caregiver's cleanliness level What agents are used for hand washing, how effective are they?
- Soap and water have been the main cleaning agents; will adding a disinfectant perfect the process.
- What mechanisms are used for hand* in a hospital/places and how effective are they?
- Do other hospitals use soap, disinfectants or a combination of several methods What are we trying to accomplish?
- A reduced rate of hospital* infections.
- How to determine if the intervention is working?
- Calculation of percentage decrease/increase in the number of hospital infections will be done to determine the effectiveness of the process.
PICO questions tend to focus on the foreground; they are however far more complex since they unearth what a researcher might have left out. With four concepts that they work with, they greatly assist in clinical decision making. By comparing the intervention of the healthcare workers and the effect that they have on the patient, their purpose is revealed as beneficial to the parties involved. In this case, the focus is on reducing hospital-acquired infections through improved hygiene. With this, patients will stay for shorter durations in hospitals while healthcare workers will have a reduced workload.
Findings of the Review
In their work, Freeman et al., (2014) focused on global hand washing rends and the effect that it has on the overall societal health. The title "a systematic review of hand washing practices worldwide and update of health effects" helps to bring the topic into focus. For them, the research showed that hand washing after possible contact with human waste was a practice still far from being universally done. The average hand-washing rate stood at 19% (Freeman et al. 2014). The results which were based on 43 studies and from 19 countries showed that there was little variance between regions. In high-income countries, the data varied between 48-72% while the rate was lower in low-income nations ranging between 5-25% (Freeman et al., 2014). The researchers'...
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