Handwashing in Patient Care: A Historical Perspective - Essay Sample

Historical Background

The significant of handwashing when it comes to patient care was adapted and conceptualized in the 19th century, Center for Disease Control and Prevention(CDC )published guidelines on the handwashing practices in the healthcare setting for the first time in the year 1975(Toney-Butler, & Carver, 2018). By then, it championed for washing hands using non-antimicrobial soap. The alcohol-based solutions were only recommended in situations where there were no sinks. Later, in the year 1995, the advisory committee for the hospital infection control practices recommended the use of antimicrobial soap or waterless antiseptic agent (Zil-E-Ali, Cheema, Ullah, Ghulam & Tariq, 2017). The chemicals could be used in situations where patients were leaving rooms where they were infected with multi-drug resistant pathogens. In the year 2002 CDC handwashing guideline recommended for the use of alcohol-based hand rubs when washing hands (Toney-Butler, & Carver, 2018). They also urged the utilization of liquid soap and water when cleaning the soiled or contaminated hands. The rising burden of hospital-acquired infections has now called for any healthcare professional to maintain handwashing hygiene. The World Health Organization has also launched the handwashing hygiene campaign in this case.

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Handwashing and Hospital-Acquired Infections

Hospital-acquired infections are also referred to as nosocomial infection. Such infections are mainly acquired in hospitals as patients receive a cure for surgical or even medical conditions. The diseases can be purchased in any care settings, for instance, surgical centres, long-term care facilities, hospitals and ambulatory clinics (Zil-E-Ali, Cheema, Ullah, Ghulam & Tariq, 2017). Any hospitalized patient is susceptible to contracting any of the Hospital-acquired infection. However, there are some categories of patients who are at a higher risk of acquiring nosocomial infections than others. The infants, elderly, and those individuals with compromised immune systems. Other risk factors in this situation include the use of indwelling catheters, extended stays in hospitals failure of healthcare officials to wash hands as well as the overuse of antibiotics. The Hospital-acquired infections are so widespread. In the US alone, the data from the Centres for Disease Control estimates 1.7 million infections. The disease has led to the death of 99,000 patients in the last year (Karaoglu & Akin, 2018). Out of these infections, 22% are surgical site infections. More so, 15% of these infections are pneumonia, while 14 % are bloodstream infections (Karaoglu & Akin, 2018).

Patients who acquire these infections from surgery have been spending around six and a half days in the healthcare facility. Most likely, they get readmitted, and many of them die in the process. Sixty per cent of the patients who get readmitted due to hospital-acquired infections go to the intensive care unit. Surgical diseases are so prevalent to the extent that they cost over 10 billion dollars annually to patients.

Based on the World Health Organization's recommendation, hand hygiene is the most effective technique to control these Hospital-acquired infections. The nurses should always get the most updated information regarding hand hygiene because of the critical role that they play in the patent's care. Nurses are the essential members of the infection control team in the healthcare setting because of the vital role they play in the hospitals.

According to the study by Malekmakan et al., 32, in the survey about hand hygiene in the healthcare members, nurses lack sufficient knowledge concerning standard precautions (Brennan et al., 2018). Most of them tend to believe that wearing gloves is enough and no need to wash hands. The majority of the research that has been conducted has emphasized that healthcare officials and professionals should maintain a high level of handwashing hygiene as they carry out their duties. Hand hygiene contributes significantly when it comes to keeping the patients safe. It is cost-effective and straightforward techniques that prevent the spread of many microbes that result in Hospital-acquired infections.

In case the hands are not visibly contaminated, the alcohol-based hand rubs are encouraged when decontaminating the hands. One situation is before the nurse gets into contact with the patient, just before donning any sterile globes at the time he/she is inserting the central intravascular catheter(Karaoglu & Akin, 2018).. Also, one should wash hands after contact with the patient's skin. After contact with body fluids of the patient's, the nurse should wash hands immediately.

In many developed and developing countries, compliance with handwashing hygiene in hospitals has been deficient. Many reasons explain this suboptimal practice, varying from available resources and settings. Some of the reasons include insufficient equipment and infrastructure that facilitate hand hygiene performance. Religious beliefs and cultural traditions also hinder the excellent practices (Zil-E-Ali, Cheema, Ullah, Ghulam & Tariq, 2017). The main factors that determine poor hand hygiene practice include belonging to a given category of profession, for example, nursing assistant, doctor and psychotherapist. Another factor is working in the specific care field, like surgery, intensive care unit, and emergency medicine. Other facto is overcrowding in hospitals as well as understaffing. There are also individual factors like social-cognitive determinants which provide additional insight into hand hygiene behavior.

Significance of Handwashing Hygiene to Nursing Practice

Most of the germs that cause Hospital to acquire infections are spread through the hands of either nurses, doctors or other workers within the healthcare setting. Studies have indicated that healthcare providers are reluctant when it comes to handwashing hygiene as they do so less than half of what they should. The situation has resulted in every 1 out of 25 patients suffer from Hospital-acquired infections each day (Brennan et al., 2018). The worrying situation is that every patient is at a very high risk of getting infected while they are getting medication for something else. More so, the healthcare provider is at risk of acquiring infections while they are treating the patients. Therefore, it is essential to prevent the spread of germs in hospitals and other healthcare facilities.

PICOT Questions

• Question 1: Does hand washing among health workers compared to no handwashing reduce Hospital-acquired infections?
• Question2: Is the use of soap and water or alcohol-based rubs more effective in preventing hospital infections?
• Questions3: Does the use of waterless, alcohol-based hand sanitizer in addition to handwashing with antiseptic soap and water by patients in neonatal intensive care unit reduce the number of Hospital-acquired infections?

References

Brennan, R. E., Bragg, A., Braden, M., Ceasar, K., Coleman, A., Drevets, P, & Proffer, J. (2017, February). Impact of Hand Washing Instructions on Hand Hygiene Practices at the University of Central Oklahoma. In Proceedings of the Oklahoma Academy of Science (Vol. 96).Retrieved from https://ojs.library.okstate.edu/osu/index.php/OAS/article/view/7211

Karaoglu, M. K., & Akin, S. (2018). Effectiveness of Hygienic Hand Washing Training on Hand Washing Practices and Knowledge: A Nonrandomized Quasi-Experimental Design. The Journal of Continuing Education in Nursing, 49(8), 360-371. Retrieved from https://www.healio.com/nursing/journals/jcen

Toney-Butler, T. J., & Carver, N. (2018). Hand, Washing (Hand Hygiene). In StatPearls [Internet]. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470254/

Zil-E-Ali, A., Cheema, M. A., Ullah, M. W., Ghulam, H., & Tariq, M. (2017). A survey of handwashing knowledge and attitudes among the healthcare professionals in Lahore, Pakistan. Cureus, 9(3). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388362/