Decreasing Risk of Infection Through Hand Hygiene

Evidence based practice (EBP) is the conscientious use of current best evidence and a problem-solving tactic to clinical practice that incorporates patient ethics and preferences from well-designed studies for constructing decisions about patient care. Healthcare is evidence based and grounded in knowledge derived from scientific research and moralities. Conducting EBP and nursing research studies add to scientific knowledge of nursing practice thus advancing nursing practice and optimizing patient results. Incorporating EBP protocols into every day practice helps nurses meet the professional responsibility identified in the ANA Code of Ethics for Nurses Provision 7.3: “to advance the nursing profession through knowledge development, dissemination, and application to practice”. To this day, hand hygiene a well-known EBP. It is a critical, essential, and fundamental practice to prevent healthcare-associated infections. Although a fundamental practice, nurses and all healthcare professionals continue to struggle everyday with hand washing procedures with less than 50% compliance rates. It is crucial for healthcare workers and facilities to provide continued education on the basics of nursing practice, like hand hygiene, in order to promote the importance of essential nursing fundamentals.

Literature Review

It takes 15-30 seconds to effectively wash your hands, thus providing immediate protection to yourself and to patients. In the short amount of time it takes to wash your hands, you can reduce the morbidity rates, mortality rates, cost of care, length of hospital stay, and recovery time for patients. Hand hygiene is known as the easiest and most economical way to reduce healthcare-associated infections (HAI). The World Health Organization (WHO) established guidelines explaining when hand hygiene should be completed including: “before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings”. The Centers for Disease Control (CDC) estimate that nearly two-million patients contract at least one hospital-related infection every year and nearly 99,000 patients die from the attracted infection. Hand hygiene is vital in decreasing HAI while providing safe and high-quality patient care. 20-40% of nosocomial or health care-associated infections are preventable. Nursing professionals must wash their hands, as indicated by the WHO, in order to prevent such health care-associated infections. If a nurse chooses not to wash his or her hands due to the belief that it is unnecessary, it dries out their skin, or it wastes their time, that nurse compromises the quality of care that he or she is giving to the patient, ultimately risking the safety of all patients, medical professionals, and himself or herself.

Nursing Implications and Discussion

An infection will remain intact if the chain of infection is present and it is everyone’s responsibility, including the patient, to break that chain at all times possible. It is impeccable for healthcare workers, such as nurses, to provide education to patients and family members defining the importance of hand washing. The CDC states, “handwashing can prevent about 30% of diarrhea-related sicknesses, about 20% of respiratory infections, and absenteeism due to gastrointestinal illness in schoolchildren by 29-57%”. When educating others, it is imperative not to assume that they know effectively and correctly wash their hands. Key factors in educating others of proper hand washing with soap and water involves lathering your hands with the appropriate amount of soap and vigorously rubbing them together applying friction to remove microorganisms for 15-30 seconds, followed by rinsing them with warm water. The CDC recommends singing the “Happy Birthday” song twice from beginning to end as a timing mechanism. It is also important to know that applying an antiseptic sanitizer is a form of effective hand washing. An effectively antiseptic hand rub is one that is alcohol-based. When educating others of the proper use of alcohol-based hand rubs, emphasize that the hands need to be continuously rubbed together until they are completely dry. Emphasizing the techniques of proper hand washing and enforcing the “Nursing Scope and Standards of Practice” promotes and maintains health by always providing safe and quality care in all healthcare organizations.

Conclusion

In conclusion, it is critical to enforce fundamental health care protocols, such as hand hygiene. Nursing professionals come into contact with many patients on a daily basis as nursing is one of the largest divisions of healthcare staff. This means there are more opportunities for implementing and educating the practice of proper hand hygiene and soliciting patients to help decrease the spread of infections. It only takes one person to aid in decreasing the risk for a HAI. Hand washing regularly can advance healthcare across an organization.

References

• Ackley, B. J., Ladwig, G. B., Makic, M. B. F., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: an evidence-based guide to planning care (12th ed.). St. Louis: Elsevier.
• Akanji, J., Walker, J., & Christian, R. (2017). Effectiveness of formal hand hygiene education and feedback on healthcare workers’ hand hygiene compliance and hospital-associated infections in adult intensive care units. JBI Database of Systematic Reviews and Implementation Reports, 15(5), 1272–1279. doi: 10.11124/jbisrir-2016-003019
• Fulton, J. S. (2018). Publishing Evidence-Based Practice Projects. Publishing Evidence-Based Practice Projects. 
• Handwashing - Clean Hands Save Lives. (2020, January 14). 
• Hand Hygiene. (2017). Hand Hygiene, 1–7. 
• Mick, J. (2017). Call to action. Nursing, 47(4), 36–43. doi: 10.1097/01.nurse.0000513603.03034.5c
• Nursing Scope of Practice: American Nurses Association. (n.d.). 
• Perkins, A. (2017). Hand Hygiene, The most important thing you can do for your patients. Hand Hygiene, He Most Important Thing You Can Do for Your Patients, 1–7.
• Show Me the Science. (2015, July 22). 
• Show Me the Science - How to Wash Your Hands. (2019, July 12).