Hand-washing vs Alcohol Gels in Infection Prevention - Coursework Example

Hand washing vs alcohol gels in infection prevention Introduction: This paper is concerned with the question of superiority of alcohol gels in the prevention of infection over conventional hand washing, using soap and water, or liquid soap, etc. This paper will also delve into the aspects governing hand hygiene and need for nursing staff and careers to keep their hands always clean and sanitized to prevent and protect against chances of contracting and transmitting infections, or being carriers for germs or bacteria. Purpose of Research Statement: It is believed that hand washing by use of alcohol gels is superior in the maintenance and preservation of hand hygiene and sanitation when compared to conventional soap and water /liquid soap wash. Identification of problem or issue in work settings: The main problem that arises is the high probability of transmission of infections from one person to another, or from doctor to patient, or vice versa. It is observed that a vast number of patients having MRSA have frequent contact with health care providers, and this increases the risks involved. Moreover, hand washing for less than 30 seconds does not clean all bacteria, and therefore it is necessary for hands to be thoroughly washed for more than 30 seconds in order to be relatively free of known infection agents and microorganisms which could rapidly cause infection. (Fantina, 2006, p.153). In the context of professional point of view of hospital heath care, it is seen that there could be three scenarios that need to be dealt with, in the context of hand washing, viz: 1. To remove germs and bacteria acquired from one patient before going to the next patient, in effect the HCP needs to wash his hands after each examination, also known as transient flora. 2. To take necessary steps to counteract and destroy germs within HCP’s own person also termed as resident flora, which is of a more obdurate kind 3. To ensure that proper washing is done to avoid germ activities in settings. (Rotbart, 2007, p.270). Formulation of PICO Statement: The PICO statement is being analyzed as follows: P= Problem, in that Population, that is the concern that nursing faculty may transmit virulent germs, etc. I= It stands for all kinds of interventions, both alcoholic and hand washing with soap, C= Comparison discussion, the best course of action beneficial to both HCP’s and patients to be henceforth followed O= Outcome, or the results of the comparative study on which is more health friendly, and assures of lesser risks of user contracting infection through micro-organisms, or germs. (Introduction provides preview of the paper, (n.d)). The problem statement is that traditional washing of hands by health care professionals is not safe and need to be reinforced by safer and speedier method. This could be in terms of alcohol based gels that have several advantages and needs to be promoted more assertively for the benefit of the medical community. Assessing background information for Problem which includes: The main problem that emanated was in terms of the lowered standard of health hygiene that could be witnessed, either by not washing hands regularly, or washing it just perfunctorily, by which the germs are not totally eliminated and could be transmitted to other patients or to oneself. This being said, it is now essential that research needs to be conducted that could possibly address how such risk could be eliminated by health care professionals and care givers. It is quite possible that such conditions could give rise to serious ailments like C-Diff and MRSA. Stakeholders: Obviously the stakeholders are the patients and even health care professionals and careers who interact directly with patients with various kinds of diseases. It could also be seen that these people are at risk of either contracting ailments themselves, or even transmitting it to other persons. It is seen that one of the most widespread method of spreading infection in hospital settings is through hand contamination and could bring the vulnerable segments of patients, especially the ones with lowered immunity and strength to worse angst. Internal and External Evidence: The internal evidence could be the health hazards that surface due to lowered degree of hand washing, in terms of irritation, hardening and dryness of hands, or even abnormal skin conditions due to use of hard soap and other chemicals. The external evidence is the large amount of research that has been carried out by individuals, groups and agencies in the matter of comparative studies between use of soap, medically treated liquid, and other chemicals substances, like Tricosan, that has antiseptic and antibacterial properties. The main aspect that research needs to dwell on is with regard to the efficiency and beneficial aspects (without side effects) of alcohol based cleaning gels over others. Risks, Costs, Benefits: It is seen that the risks of continually using soap solutions or equivalent is well documented. As a matter of fact, the CDC have mentioned that “although hospitals have provided personnel with non-antimicrobial soaps in hopes of minimizing dermatitis, frequent use of such products may cause greater skin damage, dryness, and irritation than antiseptic preparations.” (Boyce, & Pittet, 2002). It is quite possible that nursing care personnel may contaminate their hands while negotiating patients and may later forget, or hastily wash their hands. This may lead to colonization of the condition that could either cause dermatological hazards to themselves, or to the people they care for. The benefits that accrue could be in terms of actions taken for remedying situation and taking positive steps to alleviate the risks of contracting, or transmitting virulent conditions to others. Available Resources: The survey would depend upon secondary research already conducted on the subject, including internet searches, books and literature from journals and medical sources, and other validated materials. It could also be seen in terms of the opinions of health care professionals through interviews held with them from time to time. Appropriate Sources for Information: Authenticated government websites like PubMed, CDC internet sites, book searches from Google and other genuine sites would be used for the purpose of the study. Ethical /Moral implications: In a research of this kind, it is necessary to protect identity and responses of the respondents. Therefore, all matters relating to the research shall need to be dealt with utmost confidentiality and privacy, and the information supplied by them need to be used only for the purpose of research by duly authorized personnel and nobody else. It is necessary that Data that forms the core of this study shall be kept in safe custody with access to authorized person only. Interview with a Nurse to give historical perspective: Interview was conducted with a nurse regarding the benefits of using alcohol based gels as a better alternative to conventional soap and water treatment. It has been observed that she considers herself to be hard-pressed for time, being called upon to provide care and attention to many patients at a time. Thus, she finds it difficult to even attend to writing work and therefore, it may be difficult to indulge in washing hands after seeing each patient, since that would take away a lot of time that could otherwise be used for benefit and care of her patients. Besides, it is also necessary that he wash rooms or basins are conveniently and nearby located so that she could spend around 20 seconds just going and coming back from the sinks. If sinks are kept very far away, it could deter nursing faculty from making long trips and thus burning out productive time. The nurse feels that alcohol gels do not need water treatment and thus could be used on the move, from place to place with relative ease and convenience. It is speedier, convenient and is more likely to be effective and efficient than conventional soap and water solutions or even medicated soaps or chemicals. Thus, it is seen that nursing faculty prefers to use non soap in most cases where alternative are possible. It could also be said that gels provide the needed risk protection against infections and other transmission of diseases through human contact. Search terms: Hand washing: Washing hands with plain, non-antimicrobial soap water. Hand hygiene: A general term that applies to hand washing, antiseptic hand wash, antiseptic hand rub, or surgical hand antisepsis. (Boyce, & Pittet, 2002). Plain soap: Plain soap refers to detergents that do not contain antimicrobial agents or contain low concentrations of antimicrobial agents that are effective solely as preservatives. Plan the change/development of a solution, considering: Obtaining approvals: It is necessary to get endorsement from concerned authority in charge of administration of medical hospital where this survey would be conducted. It would also be necessary to take department permission from the health care professionals under whom the nurses are assigned, seeking permission for participating in this survey. The personal interviews and discussions would also include those of prominent health care administrators and managers, in this establishment, seeking their views in the matter. Pilot study indicated: It is seen that the pilot study would be needed to be conducted using sample study of 32 nurses in the hospital setting for gaining knowledge and information about the comparative benefits of using alcohol gel based materials over soap and water treatment methods. The research design would be a randomized study conducted over a period of 8 weeks, to assess the relative effects of both soap and water and alcohol gel based material on skin and topical health. The report would be presented after a period of eight weeks and would address issues regarding the comparative advantages of alcohol gel over conventional methods. Determining method of communication and education: The method of communication would be through face to face deliberations with the selected nursing faculty to determine the efficacy or non-efficacy of the research question as to whether alcohol gel would be more effective and efficient than conventional treatment Implementing the change: The results of this survey proved unanimously that indeed alcohol was better suited for hand wash in the health care sector especially in the caring of patients through physical interventions. The results of the tests proved that “Hand antisepsis with an alcoholic-hand-gel regimen was well tolerated and did not result in skin irritation and dryness of nurses hands. In contrast, skin irritation and dryness increased significantly when nurses washed their hands with the unmediated soap product available in the hospital. Newer alcoholic hand gels that are tolerated better than soap may be more acceptable to staff and may lead to improved hand-hygiene practices.” (J.M, Boyce., M.S, Kelliher., & R.N, Vallande, (n.d)). Pilot study: Upon completion of the pilot survey, it is seen that the survey was taken up and conducted in the presence of senior health care professionals and faculty of the University. The interviews were conducted according to established norms and customs and the results were duly authenticated by the medical faculty Process for measuring outcomes: Statistical tools were used for determining the outcome of the study. Consider how to evaluate the change in practice and whether to alter, accept or reject proposed changes “Several recent prospective, randomized trials have demonstrated that alcohol-based hand rubs containing emollients were better tolerated by HCWs than washing hands with non-antimicrobial soaps or antimicrobial soaps.” (Boyce, & Pittet, 2002). Review of PICO: It is seen that through use of PICO, the problem has been identified and the need to change over, at least on a test basis has been sanctioned by the administrators of this particular health setting. The outcomes, or the results of the study are suggestive of the fact that alcohol based gels are more health friendly, and assures of lesser risks of user contracting infection through micro-organisms, or germs. Process, outcomes & evaluation methods that will be employed for change The process that would be used for change would be first based on a selective and sample test basis in one department, or area of the healthcare setting. This being said, the costs and benefits analysis of such change would be constantly monitored over a period of time and the results determined. It could also be seen in terms of the fact that the sample study would give way to larger study, perhaps with larger number of respondents that could correctly address the problem and its outcomes. The data base of this research would underpin and support the larger research study if need be, and could form the source materials for the bigger research study which would attract a larger population and scope of research action. Conclusions: It has been evidenced both from empirical studies and theory that alcohol gel could have larger advantages in terms of the fact that it does not need water, it is speedier to use and has greater propensity to deal effectively with germs, with low concentration, than possibly what conventional soap water or chemical treatment could achieve. However, it is necessary to conduct a larger research study, in order to get a better and bigger picture of the study. Reference Boyce, John M., & Pittet, Dider. (2002). Guideline for hand hygiene in health- care setting: recommendations of the health care infection control practices advisory committee and the HICPAC/SHEA/ APIC/IDSA hand hygiene task force: proposed methods for reducing adverse effects of agents. CDC. Retrieved May 23, 2009, from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm Boyce, John M., & Pittet, Dider. (2002). Guideline for hand hygiene in health- care setting: recommendations of the health care infection control practices advisory committee and the HICPAC/SHEA/ APIC/IDSA hand hygiene task force. CDC. Retrieved May 23, 2009, from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm Fantina, Robert. (2006). Desertion and the American soldiers, 1776-2006. Algora Publishing. 153. Retrieved May 23, 2009, from http://books.google.com/books?id=EW1Bk8VulK4C&pg=PA160&dq=ALCHOHOLIC+GEL+V.+SOAP+ETC&ei=I2QWStzhO4LClQTOnunCCw#PPA153,M1 J.M, Boyce., M.S, Kelliher., & R.N, Vallande. (n.d). Tire due document/ document title: Resume/abstract. Cat.Inist. Retrieved May 23, 2009, from http://cat.inist.fr/?aModele=afficheN&cpsidt=1443234 Introduction provides preview of the paper. (n.d). (provided by customer) Rotbart, Harley. A. (2007). Germ proof your kids: The complete guide to protecting (without overprotecting) your family from infection. ASM Press. 270. Retrieved May 23, 2009, from http://books.google.com/books?id=vHUsTw-IdoYC&pg=PA268&dq=Reports+on+handwashing&ei=yXkWSqjsF4uwkASboeD2CQ#PPA270,M1 Read More