Hand Washing in a Health Care Setting: Is Alcohol Gel as Effective as Hand Washing in a Hospital Setting - Essay Example

? Hand Washing in a Health Care Setting Is Alcohol Gel as Effective as Hand Washing in a Hospital Setting Introduction Ill health can often be associated with poor hand hygiene and sanitation. (Bartram; Cairncross, 2010) The World Health Organization considers hand hygiene as a fundamental means to prevent nosocomial infection, but conformity of this practice in the health care setting is often low. (Kampf; Loffler; Gastmeier, 2009) The study will delve on hand washing in a health care setting. It would focus on the premise of determining whether the use of alcohol gel is as effective as hand washing in a hospital setting. In order to find literature pertaining to the study at hand, parameters were established. In considering the context of the topic, criteria had been formulated in terms of identifying the subject and the locale. Since the setting of the study is in a health care center, one criterion identified is a health care worker's compliance with hand hygiene policies, in relation to the patient. The literatures are supposed to elaborate on the proper observance of hand hygiene principles, in comparison of using alcohol gel against hand washing. All the data gathered were secondary sources for they are journals at the University of Hertfordshire database. In searching for journals, terms and strategies were utilized to locate appropriate articles. Journals of Hospital Infections were used to categorize specific articles, since the study aims to illustrate the efficaciousness of alcohol gel against hand washing. This can be examined through hospital journals, in which infections have been caused by improper hand hygiene. No primary data had been collected as the researcher did not conduct interviews in a health care in regards to hand hygiene compliance. There were hardly any restrictions in searching for literature needed to support the study, since the topic chosen is definite and feasible. Only the year of publication has been pegged as an inclusion criterion, since recent research is ideal. All journal articles were peer-reviewed and published no older than 2005. DATABASE University of Hertfordshire SEARCH TERMS Journal of Hospital Infection PAPERS OBTAINED FOR REVIEW Hygiene, Sanitation, and Water: Forgotten Foundations of Health The effect of hand hygiene on illness rate among students in university residence halls Prevention of diarrhea and dysentery by hand washing Hand hygiene for the prevention of nosocomial infections Hand Washing, a Key Anti-Flu Strategy, Often Neglected by Health Care Workers Healthcare workers’ compliance with glove use and the effect of glove on hand hygiene compliance.   Interventions to improve hand hygiene compliance in patient care.   Outbreak of Serratia Marcescens in a neonatal intensive care unit: contaminated unmedicated liquid soap and risk factors.   Systematic patients’ hand disinfection: Impact on methicillin-resistant staphylococcus aureus infection rates in a community hospital.   24 hour observational study of hospital hand hygiene compliance. Healthcare workers’ Compliance with Glove Use and the Effect of Glove Use on Hand Hygiene Compliance There are studies that indicate that there is a correlation between hand sanitation and infection control in various settings such as hospitals and health care facilities. (Kolble, et al., 2005) The article Healthcare workers’ compliance with glove use and the effect of glove use on hand hygiene compliance states that inappropriate hand hygiene is one of the leading causes of healthcare-associated infection. The study was conducted due to low recommendations of infection control among health care workers, as practiced by non observance of proper hand hygiene. The study focused on the effects of the use of gloves in relation to hand hygiene, in the method of observation. Though it has been cited that wearing of gloves reduce the transmission of pathogens, it still runs the risk of hand contamination after its removal. The researchers found out that most health care workers adhered to the use of gloves during operations at wards within the health care center, with a rate of 92%. Unfortunately, though this policy was followed, another problem originated from it, which is the overuse of gloves at 42%. These statistics show that even though health care workers comply to the policy of using gloves, they fail to adhere to hygiene qualifications that leads to the over use of gloves; therefore, reducing the rate of hand hygiene compliance to 64%. (Flores; Pevalin 2006, 19) Practicing proper hand hygiene is the leading preventive measure for healthcare-associated infection. As indicated in the article, health care workers rarely wash their hands after removing their gloves, in the belief that gloves protect their hands from contamination. This notion might be valid on the part of the healthcare worker, but it would imply a negative effect on the patient's side. Gloves can be contaminated the same way that hands are, albeit it doesn't eliminate the risk of infection. Through the method applied in the study, two options were provided to health care workers in the locale of the research, which is a large hospital. In every bay and room is a sink with liquid soap and paper towels, while alcohol gels were placed outside the rooms and bays. Doctors, nurses and health care assistants were observed. Hand washing was identified specifically as the action of washing hands with soap and water to remove dirt, which excludes surgical hand scrub; whereas hand disinfection is identified by using antiseptic solutions such as alcohol gels, to clean the hands. Hand hygiene in general, was referred to as the decontamination of hands. (Flores; Pevalin 2006, 18) The study concluded that the cause of low hygiene compliance within a health care center is the over use of gloves, which led to the recommendation of mandating the behavior of health care workers' glove use. In essence, they should be more aware and responsible to know that they should regularly replace their gloves to practice proper hand hygiene, thus, decreasing the risks of infection. The discussion of the study conducted was that gloves were worn at times that are not needed, further increasing the risk of cross-infection. It is highly advised for gloves to be worn only once, and only when needed. Apart from that, hand disinfection, through washing or using antiseptic solutions is highly advised after the removal of gloves. Interventions to Improve Hand Hygiene Compliance in Patient Care Most cases that lead to death are cause by health care-associated infection. To prevent this, appropriate hand hygiene is considered the most effective and simplest method. In spite of that, health care workers perform practice of abiding to hand hygiene policies. The study conducted on the Interventions to improve hand hygiene compliance in patient care aimed to implemented methods that would modify health care workers' behavior towards hand hygiene for short term and long term effects. In lieu with this objective, the researchers were to identify if health-care associated infections would increase if the methods applied in the study were effective. Due to lack of resources to substantially support the study, especially to determine long term implications, the researchers concluded that the only means for an intervention to have a successful impact on changing health care workers' hand hygiene compliance is through educating the health care workers verbally and through written material, continuously. This method was proven more effective than supplying hygienic goods which they tend to ignore. Unfortunately, no definite method was found effective that can produce long term effects, in hopes of increasing hand hygiene to eliminate infection risks (Gould, Drey, Moralejo;, Grimshaw, & Chudleigh 2008). The study concluded that the poor hand hygiene compliance can be correlated to the non-existence of an educational program that promotes and supports proper hand hygiene. The study was not able to establish the difference on the implication of utilizing alcohol gels against regular hand washing as a means of intervention in improving hand hygiene compliance. Outbreak of Serratia Marcescens in a Neonatal Intensive Care Unit: Contaminated Unmedicated Liquid Soap and Risk Factors The Outbreak of Serratia marcescens in a neonatal intensive care unit: contaminated unmedicated liquid soap and risk factors is a case-control study that aimed to identify whether using soap dispensers in regular hand washing may have been the source of nosocomial infections that led to the outbreak. The study identified that the use of alcohol gels for hand disinfection is the key factor that resolved the crisis. The researchers established that the infection of the nosocomial pathogen Serratia marcescens outbreak in the locale of their study, which is a neonatal intensive care unit, is due to the contaminated hand soap or tap water used by the health care workers for washing hands. After assessing the babies whose pathogens were either infected or colonized, the researchers found that proper hygienic precautions were applied for the devices and tools used in handling the babies, as well as the environment. The infection control audit indicated that the use of gloves and antiseptic solution for disinfecting were not observed properly. After examining the tap water and the soap dispenser in the unit, results show that the tap water showed no signs of the pathogen; while the soap dispensers had a culture of Serratia marcescens. The sample found in the soap dispensers had the same epidemic strain that manifested on the babies at the neonatal intensive care unit. As for resolution, the method applied was to replace their previous soap dispensers with "airless" dispensers in every room, which aims to eliminate the epidemic strain and prevent it from forming a culture. Apart from that, the use antiseptic solutions were strongly encouraged. In spite of that, another case had been identified. Thereafter, the use of soap dispensers had been prohibited and the use of alcohol-based hand rub was strongly reinforced. The substitution of regular hand washing to the use of anti-septic solutions for hand disinfection had been effective for the neonatal intensive care unit, for no epidemic cases have been identified since then. (Buffet-Batalion, Rabier, Betremieux, Beuchee, Bauer, Pladys, Le Gall, Cormier, Jolivet-Gougeon, 2009). Systematic Patients’ Hand Disinfection: Impact on Methicillin-Resistant Staphylococcus Aureus Infection Rates in a Community Hospital The study's objective was to address the possible transmission of pathogens in the hospital through patients and their relatives in the hospital. The researchers believe that visitors or guests at the hospitals may be unidentified carriers of Staphylococcus aureus (MRSA), which may possibly be a cause of infection at health care centers. To observe and verify the hypothesis presented, an experiment had been conducted in a year where anti-septic solution disinfection had been enforced for all patients' and visiting relatives. The process of the experiment was also assessed by the rates of nosocomial infection during the trial period. Several method have been previously implemented to campaign proper hand hygiene practice among hospital guests such as hand washing re-enforcing campaigns, nasal screening of "at-risk" patients, availability of waterless alcohol rinse products, and staff hand washing audits. (Gagne; Bedard; Maziade 2010, 270) A team of infection control attendants have been formed, to supervise and advise all the patients' and visiting relatives to practice the policy of using an alcohol gel twice a day to clean their hands every weekdays. In coherence with this protocol, certain studies have been evaluated, particularly rates of Staphylococcus aureus infections, the hand hygiene compliance of health care personnel and analysis of cost and benefit. In the span of a year, the research was able to identify a remarkable decrease of MRSA infections by 51%. (Gagne, Bedard, Maziade, 2010). The study concludes that proper hand hygiene should not only be enforced towards health care workers, but to external visitors as well, such as patients and visiting relatives. Systematic practice of hand hygiene proves to be an inexpensive and effective means of preventing nosocomial transmission. Twenty-four-hour observational study of hospital hand hygiene compliance The study observed the behavior of health care workers, patients and visitors towards hand hygiene observance in a period of 24 hours. The setting of the observation was focused on two hospital wards, utilizing a tool named as the "five moments of hand hygiene". Hand hygiene facilities and resources were present at each entrance of both wards, at bedsides and regular points within the hospital. The research was influenced by the fact that hand hygiene is the most effective means of preventing infections, but the rates of adherence had been dismal. The compliance rates among health care workers are as follows: 47% for doctors, 75% for nurses, 78% for health professionals, and 59% for other staff. As for patients and visitors, the rate recorded is at 56 and 57%, respectively; whereas, the overall compliance is at 67.8%. The factors affecting these results are as follows: heavy workload, scarcity of time and resources, behavior and professional grouping. (Randle, Arthur, & Vaughan 2010). The study concludes that health care workers are more prone in transmitting pathogens and causing infections due to poor compliance to hand hygiene, making it a universal crisis. This diminishes a health care facility's credibility to provide safe health care and high quality service. The study recommends that everyone within the health care facility should practice proper hand hygiene before and after contact with people or devices. As hand hygiene, whether through hand washing or by using anti-septic solutions such as alcohol gels, is an influential and cost-effective means of decreasing HCAIs. (Randle, Arthur, & Vaughan 2010). Conclusion Health officials must be able to recognize the significance of hand washing as the first line of defense in preventing illnesses and infection. Predominantly in health care settings, hand antisepsis is one of the most critical factor in reducing the proliferation of pathogenic microorganisms and restricting health-care associated contamination. (Mitka, 2009) It has been proven that hand washing is an hand washing is a valuable means in limiting morbidity from common illnesses such as diarrhea and dysentery. (Han; Hlaing, 2008) Hand Hygiene is a critical aspect in maintaining a safe environment, especially in a health care setting. Based on the information gathered, hand disinfection is important, whether by means of regular hand washing using a soap and water or through the use of anti-septic solutions such as alcohol gels. Though for certain situations, such as the case in the journal Outbreak of Serratia Marcescens in a neonatal intensive care unit: contaminated unmedicated liquid soap and risk factors, anti-septic solutions are better alternatives instead of hand washing. Apart from that, use of alcohol gels are strongly encouraged since the availability of such resources are more frequent than finding sanitary basins within the hospital, since anti-septic solutions are portable in nature and its more convenient to apply. In spite of that, thorough hand washing is still advised to eliminate pathogen strains. References Buffet-Batalion, S., Rabier, V., Betremieux P., Beuchee A., Bauer, M., Pladys, P., Le Gall, E., Cormier, M, & Jolivet-Gougeon, A. (2009). Outbreak of Serratia Marcescens in a neonatal intensive care unit: Contaminated unmedicated liquid soap and risk factors. Journal of Hospital Infection, 72 (1), 17-22. Flores, A. & Pevalin, D. (2006). Healthcare workers’ compliance with glove use and the effect of glove on hand hygiene compliance. British Journal of Infection Control, 7 (6), 15-19. Gagne, D., Bedard, G., & Maziade, P.J. (2010). Systematic patients’ hand disinfection: Impact on methicillin-resistant staphylococcus aureus infection rates in a community hospital. Journal of Hospital Infection, 75 (4), 269-272. Gould, D.J., Drey, N.S., Moralejo, D., Grimshaw, J., & Chudleigh, J. (2008). Interventions to improve hand hygiene compliance in patient care. Journal of Hospital Infection, 68 (3), 193-202. Randle, J., Arthur, A. & Vaughan, N. (2010). 24-hour observational study of hospital hand hygiene compliance. Journal of Hospital Infection, 7 (3), 252-260. Mitka, M. (2009) Hand Washing, a Key Anti-Flu Strategy, Often Neglected by Health Care Workers. JAMA, Vol. 302, No. 17, 1850-1851 Kampf G., Loffler H., Gastmeier P. (2009) Hand hygiene for the prevention of nosocomial infections. Deutsches Arzteblatt international, Vol. 106, No. 40, 649-655 Han, A., Hlaing T. (2008) Prevention of diarrhoea and dysentery by hand washing. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 83, No. 1. Kolble, R., White, C., Carlson R., Lipson, N., Dolan, M., Ali, Y., Cline, M. (2005) The effect of hand hygiene on illness rate among students in university residence halls. Am J Infect Control, Vol. 31, No. 6, 364-370. Bartram, J., Cairncross, S. (2010) Hygiene, Sanitation, and Water: Forgotten Foundations of Health. PLoS Med, Vol. 7, No. 11. Read More