Hand Hygiene: A Frequently Missed Lifesaving Opportunity during Patient Care - Term Paper Example

 Hand Hygiene: A Frequently Missed Lifesaving Opportunity during Patient Care Table of Contents I. Introduction ……………………………………………………………… 4 II. Thesis Statement ……………………………………………………….. 4 III. Guidelines on Proper Hand Washing and the Use of Alcohol-Based Hand Gels ……………………………………………... 5 IV. Literature Review ………………………………………………………. 6 a. Minimize the Presence of Bacteria in the Hands of Nurses and Health Care Professionals …………………. 6 b. Reduce the Incidence of Cross-transmission of Disease Causing Micro Organisms between Health Care Professionals and Patients ………………… 6 c. Decrease the Number of Patients’ with Healthcare-associated Infections (HAI) …………………. 7 V. Conclusion ……………………………………………………………….. 8 References ……………………………………………………………………….. 9 - 10 Introduction Hand hygiene or washing the hands with soap is considered to be one of the most effective infection control measures. Despite the importance of hand hygiene, several studies reported that the number of hospital-acquired infection is approximately 1.4 million people all over the worlds (Vincent, 2003; Tikhomirov, 1987). The main purpose of hand hygiene is to reduce the number of micro organisms that are present on the hands of the nurses and health care professionals. Considering that the job of nurses requires physical contact with the patients when rendering care and treatment, washing hands with soap should be given importance in order to minimize the possibility of transmitting these micro organisms between the health care professionals and the patients (Larson et al., 2005). For this study, the guidelines on proper hand washing and the use of alcohol-based hand gels as suggested by the Centre for Disease Control and Prevention (CDC) will be provided followed by conducting a short literature review to prove that hand hygiene is a frequently missed lifesaving opportunity when rendering care to patients. Thesis Statement Hand hygiene can save the life of the patients since washing hands with anti-microbial soap reduces the following: (1) the presence of bacteria in the hands of the nurses and health care professionals; (2) incidence of cross-transmission of disease causing micro organisms between the health care professionals and patients; and (3) the number of patients’ with healthcare-associated Infections (HAI). Guidelines on Proper Hand Washing and the Use of Alcohol-Based Hand Gels Prior to washing hands with soap, nurses and health care professionals should keep their nails short to avoid harboring micro organisms (CDC, 2002: p. 46). Nurses and health care professionals are also required to remove all jewelry before washing the hands to facilitate a better and proper cleaning of hands and arms. Always gather the necessary equipments needed such as antimicrobial or regular soap, alcohol-based waterless antiseptic, paper towels or dyer, clean orange wood stick (for surgical hand washing) before washing the hands. Gathering all the equipments prior to hand washing will save more time for nurses and health care professionals. In case of skin cuts or wounds, nurses and health care professionals should cover it first after hand washing before going to a client. This way, his/her wound will not get infected with bacteria, viruses, and other micro organisms. When washing the hands, make sure to keep wet hands and wrists under running water. Always keep hands and forearms lower than the elbow during hand washing so as to avoid contaminating the clean upper part of the arms. After wetting the hands, start applying a small amount of antimicrobial soap and lather thoroughly for 10 to 15 seconds followed by drying hands using paper towel, single-use cloth, or warm air drier (CDC, 2002b). When using alcohol-based hand gels, applying a small amount of gel on palm and rub hands together until the gel covers the entire surface of the hands and fingers. Rubbing of hands should be done for several seconds until the alcohol becomes dry. (Kampf, 2004) Literature Review Minimize the Presence of Bacteria in the Hands of Nurses and Health Care Professionals Nurses and health care professionals’ hands are capable of collecting a thousand units/cm2 of micro organisms. (Selwyn, 2000) Based on the study of Lijima and Ohzeki (2006) which measured bacterial contamination on the nurses’ hands after patient care, the authors revealed that the practice of proper hand hygiene can significantly lessen the amount of bacteria present on the hands of the nurses. Upon examining the effects of using the usual hand washing using anti-microbial soap and waterless-alcohol hand gels, Larson et al. (2005) concluded that the use of both techniques is both effective in terms of preventing possible infection as well as the number of micro organisms that were found on the hands of the nurses. On the contrary, Widmer (2000) concludes that the use of ‘alcohol-based cleanser’ is not only so much easier to use but also more effective in terms of lowering down the number of micro organisms as compared to the traditional hand washing routine. Reduce the Incidence of Cross-transmission of Disease Causing Micro Organisms between Health Care Professionals and Patients The hands of the health care professionals can easily transmit micro organism from one place to another. (Simon, 2004) For this reason, several studies revealed that making hand hygiene a habit can significantly reduce the number of cases that are related with the transmission of infectious diseases from one patient to another. (Larson, 1999) Aiming to prevent and minimize the possibility of cross-transmitting infectious diseases within the hospital environment, antibacterial soap was intentionally produced to protect the patients who are admitted in hospitals from bacterial, virus, and pathogen infections. (Levy, 2001) In general, the problem that is often associated with regular hand washing using antiseptics made of detergents is that it can cause the nurses’ skin to get too dry up to the point that is damages and increases the risk of micro organisms transmission. For this reason, Larson (1999) suggest that nurses and health care professionals should consider using other hand hygine options like the ‘waterless alcohol-based products’ instead of using ‘detergent-based antiseptics’ when undergoing surgical scrub requirements. It is also advisable to use of moisturizers to protect their skin from excessive dryness. Decrease the Number of Patients’ with Healthcare-associated Infections (HAI) ‘Healthcare-associated Infections’ (HAI) is a serious health condition since it extends the patients’ stay at the hospital, increases the hospital bill as well as the patients’ risk of untimely deaths. (Cosgrove, 2006) With regards to HAI, a large number of the health care professionals throughout the United States do not practice hand hygiene regularly. (Larson et al., 2005) Among the common reason why health care professionals like nurses failed to wash their hands regularly includes the following: (1) nurses and other health care professionals either do not remember or do not have sufficient time to wash their hands before rendering patient care; (2) fear that their skin will become excessively dry and damaged; and (3) the hand rub gel and sinks is located far away from the working area of the health care workers (Pittet et al., 1999). Since it is very seldom that the health care workers will go beyond forty percent of hand washing requirements (Widmer, 2000), Starfield (2000) revealed that “almost one out of every 136 patients or 2 million patients each year are at risk of becoming seriously ill because of healthcare-associated infections (HAI)”. In worst cases, HAI can also lead to the patients’ untimely death. To effectively prevent the cases of HAI, several studies revealed that the good hand hygiene is the best way to avoid HAI and the control the spread of multi-resistant micro organisms is to clean the health care workers’ hands with ‘alcohol-based hand gel’ for a few seconds before and after providing each patients with care and treatment (Pittet et al., 2006; Hugonnet et al., 2002) Since the use of hand gels basically requires a few seconds as compared with washing the hands using anti-bacterial soap, the study of Hugonnet et al. (2002) suggest that there is a strong possibility that the use of hand rub gels will eventually be a better option that a typical hand washing with soap. Conclusion A lot of nurses and health care professionals do not comply with hand hygiene protocol. To control and prevent the possible transmission of disease causing micro organisms from one patient to another, nurses and health care professionals should make it a habit to wash their hands before and after rendering patient care. With the use of anti-bacterial soap and other preventive control measures like the use of alcohol-based hand gels, it is possible for nurses and health care professionals to save the lives of many patients since proper compliance with the washing hands with soap protocol can effectively minimize the number of cases related to healthcare-associated Infections (HAI) throughout the United States. References: CDC. (2002b, October 25). Retrieved September 26, 2008, from Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Recommendations and Reports. 51(RR16):1 - 44 : http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm CDC. (2002). Nails should always be kept short and filed; Do not wear artificial nails or extenders when providing patient care. CDC Guidelines. Draft Revision of the Guideline for Hand Hygiene in Health Care Settings. CDC. Cosgrove, S. (2006). The relationship between antimicrobial resistance and patient outcomes: mortality, length of hospital stay, and health care costs. Clinical Infectious Diseases , 42(Suppl 2):582 - 589. Hugonnet, S., Perneger, T., & Pittet, D. (2002). Alcohol-based handrub improves compliance with hand hygiene in intensive care units. Archives of Internal Medicine , 162:1037 - 1043. Kampf, G. (2004). The six golden rules to improve compliance in hand hygiene. Journal of Hospital Infection , 56(Suppl 2):3 - 5. Larson, E. (1999). Skin hygiene and infection prevention: more of the same or different approaches? Clnical Infectious Diseases , 29(5):1287 - 1294. Larson, E., Cimotti, J., Haas, J., et al. (2005). Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. Archieves of Pediatrics and Adolescent Medicine , 159(4):377 - 383. Levy, S. (2001). Antibacterial household products: cause for concern. Emerging Infectious Diseases , 7(3 Suppl):512 - 515. Lijima, S., & Ohzeki, T. (2006). Bacterial contamination on the hands of nursing staff in the most basic neonatal care. Journal of Neonatal Nursing , 12(2):53 - 55. Pittet, D., Allegranzi, B., & Sax, H. et al. (2006). Evidence-based model for hand transmission during patient care and the role of improved practices. The Lancet Infectious Diseases , 6(10):641 - 652. Pittet, D., Mourouga, P., & Perneger, T. (1999). Compliance with handwashing in a teaching hospital. Infection Control Program. Annals of Internal Medicine , 130:126 - 130. Selwyn, S. (2000). Microbiology and ecology of the human skin. Practitioner , 224:1059 - 1062. Simon, A. (2004). Hand hygiene, the crusade of the infection control specialist. Alcohol-based handrub: the solution! Acta Clinica Belgica , 59(4):189 - 193. Starfield, B. (2000). Is US health really the best in the world? Journal of the American Medical Association , 284(4):483–485. Tikhomirov, E. (1987). WHO Programme for the control of hospital infections. Chemiotherapia , 3:148 - 151. Vincent, J. (2003). Nosocomial infections in adult intensivecare units. Lancet , 361:2068 - 2077. Widmer, A. (2000). Replace hand washing with use of a waterless alcohol hand rub? Clinical Infectious Diseases , 31(1):136 -143. Read More