Hand Hygiene Education

Hand Hygiene Education
Author Name
Institution Affiliation

Hand Hygiene Education
Part A: Healthcare Problem
Description. Healthcare-related infections and multidrug-resistant organisms often cause 67 percent of deaths witnessed in hospitals, homes, schools, and other community places, such as camps and orphanages. People die a day in day out because of the infections that they contract through unclean hands. According to Sharif, Arbabisarjou, Balouchi, Ahmadidarrehsima, Kashani (2016), these infections include but not limited to Hepatitis A, airborne illnesses, and nosocomial infections. They are spread through unclean hands.
Significance. In their study, Hagel, Reischke, Kesselmeier, Winning, Gastmeier, Brunkhorst, and Pletz (2015) found that hand hygiene is the best strategy to prevent the spread of multidrug-resistant organisms and healthcare-associated infections. Hand hygiene education entails informing people on the importance of maintaining hand hygiene and how to practice hand hygiene. Therefore, the primary significance of hand hygiene education is to reduce the prevalence of healthcare-associated infections by informing people about what it means to keep their hands clean.
Current Practice. The current practices for hand hygiene include the use hand gloves and proper hand washing. The practice necessitates proper hand hygiene before aseptic procedures, before touching a patient, after touching a patient, after body fluid exposure, or after touching patient surroundings.

Today, most hand hygiene education efforts emphasize Alcohol-Based Hand Rub (ABHR) as the best product for hand hygiene. ABHR is currently used in healthcare settings as the gold standard of care. Hand washing, on the other hand, is employed in cases when hands are evidently soiled, or when one cares for a patient without wearing gloves.
Impact on Background
The lack of hand hygiene education impacts the organization and patients in several ways. First is the high prevalence hospital-acquired infections due to unhygienic practices of patients and personnel. The problem also deepens the state of poverty in the community as people spend a lot of money treating diseases that would have been prevented effectively through hand hygiene compliance. Most treatment failures witnessed care also results, either directly or indirectly, from noncompliance with hand hygiene practices. Therefore, educating people on hand hygiene can of be a paramount impact, both socially and economically
Part B: PICO
PICO Table
P (patient/problem) Healthcare-related infections and spread of multidrug-resistant organisms
I (intervention/indicator) Hand hygiene education
C (comparison) No hand hygiene education; other solutions
O (outcome) Reduced healthcare-related infections and spread of multidrug-resistant organisms
PICO Question. Among the population, does hand hygiene education lower healthcare-related infections and spread of multidrug-resistant organisms as compared to the current practice?
Part C: Search Strategy
The search strategy largely involved the use of keywords and phrases.
Keywords. Keywords used include hand hygiene, hand hygiene education, hand hygiene improvement, quality improvement, practice guideline, CNE, consensus panel, commentary and expert opinion. Although some of these keywords did not give successful results, others produced the best outcomes, with a variety updated articles.
Number and Types of Articles. In the search result 102, 387 articles came up for consideration. Of these, I selected seven most suitable ones for review. 5 of the seven were research articles while 2 were non-research articles.
Research and Non-Research Evidence
Research Evidence (Articles)
Article 1. Asadollahi, Bostanabad, Jebraili, Mahallei, Rasooli, and Abdolalipour (2015) conducted a quality improvement study that aimed to determine the knowledge of nurses in neonatal units on hand hygiene. The study also aimed to unpack key predictors of this knowledge, at both the individual and organizational levels. Consequently, to accomplish this objective, Asadollahi et al. (2015) employed a qualitative research design based on a descriptive and cross-sectional analysis of variables. The researchers surveyed the knowledge of 150 nurses about hand hygiene. After an in-depth quantitative analysis, Asadollahi et al. (2015) discovered that most of the nurses in the study had the standard level knowledge about hand hygiene. Through multivariable analysis, Asadollahi et al. (2015) also found out that nurses’ work experience and educational backgrounds were the key predictors of their knowledge regarding hand hygiene.
Based on these outcomes, Asadollahi et al. (2015) concluded that infection control units should review their hand hygiene educational strategies and accentuate the application of updated hand hygiene education guidelines. As a supportive mechanism, it is, similarly, important to qualified nurses in neonatal units. A combination of all these interventions controls the rate of spread of hospital-acquired the infection.
Asadollahi et al. (2015) is reliable and valid research evidence. The study employs all the criteria required for a valid, evidence-based examination of variables. Based on this research, it is reasonable to state that maintaining hand hygiene is essential to controlling the spread of hospital-acquired infections. Hand hygiene education, therefore, purposes to inform nurses and other players why hand hygiene is a necessary practice.
Article 2. The second research evidence is a study by Hagel, Reischke, Kesselmeier, Winning, Gastmeiers, Brunkhorst, and Pletz (2015). Hagel et al. (2015) wrote an article on the infection control and hospital epidemiology to understand the Hawthorne effect of hand hygiene practice among healthcare workers. They performed the study in an intensive care unit of a particular university hospital. The method employed was direct observation. They observed how workers complied with hand hygiene and recorded the outcome using recorded using electronic ABHR dispensers.
Hagel et al. (2015) found that both electronic devices and direct observations were in agreement in terms of hand hygiene compliance (Hagel et al., 2015). Consequently, the researchers emphasized hand hygiene as the best way to control infections and transmissions of diseases in hospitals. They recommend the use of ABHR electronic devices to observe the compliance of healthcare workers with hand hygiene practices.
This article supplements the research by Asadollahi et al. (2015) which revealed the position hand hygiene education in promoting hand hygiene compliance, and the significance of hand hygiene to the infection control. The article is well structured with adequately relevant research evidence. One limitation of the article is that fails to explain the degrees of accuracy between the data observed directly and the data recorded through electronic ABHR device. Instead, Hagel et al. (2015) merely state that the two variables match, without specifying the extent to which they match.
Non-research evidence.
Article 1. Lorenzi (2017) is the first non-research evidence. Lorenzi is an expert in Health Information Technology. Therefore, in the article, Lorenzi gives an expert opinion on how to ensure hand hygiene for busy clinical staffs using hand hygiene systems. The hand hygiene compliance monitoring system reminds healthcare workers of key hand hygiene events (Lorenzi, 2017). The system also provides the healthcare management with information to promote improved hand hygiene compliance and thus, reducing cases of healthcare-associated infections (Lorenzi, 2017).
Article 2. The second non-research evidence is Karash (2017). Karash provides a detailed and well-researched commentary on proven methods that hospitals can use to enhance hand hygiene. Karash (2017) emphasize hand washing upon entrance or exit of a patient care unit. He also emphasizes the education of healthcare workers and patients on the importance of hand hygiene when it comes to controlling the healthcare-associated infections. Additionally, Karash (2017) proposes the employment of trained, certified independent onlookers to oversee compliance with hand hygiene practices.
Part D: Evidence Matrix
Authors Journal Name/ WGU Library Year of Publication Research Design Sample Size Outcome Variables Measured Level (I–III) Quality (A, B, C) Results/Author’s Suggested Conclusions
Asadollahi, M., Bostanabad, M. A., Jebraili, M., Mahallei, M., Rasooli, A. S., & Abdolalipour Journal of caring sciences 2015 Descriptive and Cross-sectional design 150 nurses
28
sources 1. The knowledge of nurses in neonatal units on hand hygiene.
2. Key predictors of hand hygiene knowledge among nurses I A 1. Most of the nurses have standard knowledge about hand hygiene
2. Nurses’ work experience and educational backgrounds were the key predictors
3. Infection control units should review their hand hygiene educational strategies and accentuate the application of updated hand hygiene education guidelines to control hospital-acquired infections
Sharif, A., Arbabisarjou, A., Balouchi, A., Ahmadidarrehsima, S., & Kashani, H. H. Global journal of health science 2016 Quantitative & Qualitative 200 Nurses Knowledge, attitude, and performance of health workers regarding hand hygiene I B Over 74.5% of nurses have basic levels of knowledge regarding hand hygiene. Over 70.5% of nurses have a positive attitude towards hand hygiene compliance, and 87.5 percent of them portrays good performance.
Mahfouz, A. A., Abolyazid, A., Al-Musa, H. M., Awadallah, N. J., Faraheen, A., Khalil, S., & … Al-Musa, K. M. Family Medicine & Primary Care 2017 Quantitative & Qualitative 478 participants (239 males and 239 females). Abha district Healthcare workers’ hand hygiene knowledge I A Only a few healthcare workers know about hand hygiene and hence, the need for hand hygiene education
Hagel, Reischke, Kesselmeier, Winning, Gastmeier, Brunkhorst, and Pletz Infection control & hospital epidemiology 2015 Quantitative 18 Hawthorne effect of hand hygiene on hospital-acquired illnesses I A Hand hygiene compliance reduces hospital-acquired illnesses, and electronic counting devices should be used to monitor hand
hygiene compliance in health settings
Maria Malliarou, R. N., Pavlos Sarafis, R. N., Sofia Zyga, R. N., & Constantinidis, T. C. International Journal of Caring Sciences 2013 Qualitative 23 articles Significance of nurses’ hand hygiene II B Proper hand
Hygiene reduces the risk of infections and hence, the need for proper hand hygiene education.
Part E: Recommended Practice Change
All the research articles support hand hygiene education as the most appropriate method to facilitate hand hygiene and reduce cases of healthcare-associated infections in care settings. Asadollahi et al. (2015) note that infection control units should review their hand hygiene educational strategies and accentuate the application of updated hand hygiene education guidelines to control hospital-acquired infections (Asadollahi et al., 2015). Sharif et al. (2016) note that over 74.5% of nurses have the basic level of knowledge of hand hygiene. Over 70.5% of nurses have a positive attitude towards hand hygiene compliance, and 87.5 % of them shows good performance (Sharif et al., 2016). Hence, emphasizing hand hygiene education can fill these gaps. Hagel et al. (2015) also found that hand hygiene compliance reduces hospital-acquired illnesses. Likewise, Maria Malliarou et al. (2013)) also established that proper hand hygiene reduces the risk of infections. Correspondingly, Mahfouz et al. (2017) discovered, in their study, that many healthcare workers do not have sufficient knowledge of hand hygiene and hence, the need for hygiene education (Mahfouz et al., 2017).
Part F: Implementations
Key Stakeholders. Key stakeholders in the implementation of the hand hygiene education intervention will include nurses, nurse educators, patients, patient educators, and nurse administrators. Patients and nurses will be involved in the discussion of the schedules and best strategies to execute education since this intervention affects them directly. Patient educators will teach patients about hand hygiene. Nurse educators, on the other hands, will educate nurses. Nurse administrators will oversee the compliance of nurses to hand hygiene practices.
Barriers. The lack of financial resources to implement the entire program can be a major barrier. Other barriers may include cultural differences, lack of knowledge about patient’s personalities, trivial public perception, and education program scheduling problems.
Strategies for Barriers. Intensifying public campaigns to counter the impact of trivial public perception of hand hygiene education. Engaging well-trained educators to solve the problems of unclear personalities and cultural differences. Also, there will be fundraising campaigns to generate funds to facilitate the program.
Indicator to Measure Outcome. One major indicator of the outcome of the intervention will be the reduction in the cases of healthcare-associated infections. Implementors will observe this change by tracking the number admissions and readmissions to the hospital.

References
Asadollahi, M., Bostanabad, M. A., Jebraili, M., Mahallei, M., Rasooli, A. S., & Abdolalipour, M. (2015). Nurses’ knowledge regarding hand hygiene and its individual and organizational predictors. Journal of caring sciences, 4(1), 45. Karash, J. A. (2017). Hand Hygiene Do’s & Don’ts. H&HN: Hospitals & Health Networks, 91(5), 39-42.
Hagel, S., Reischke, J., Kesselmeier, M., Winning, J., Gastmeier, P., Brunkhorst, F. M., & Pletz, M. W. (2015). Quantifying the Hawthorne effect in hand hygiene compliance through comparing direct observation with automated hand hygiene monitoring. Infection control & hospital epidemiology, 36(8), 957-962.
Karash, J. A. (2017). Hand Hygiene Do’s & Don’ts. H&HN: Hospitals & Health Networks, 91(5), 39-42.
Lorenzi, N. (2017). Hand-hygiene systems provide compliance help. Health Facilities Management, 30(12), 37-40. Non-R
Mahfouz, A. A., Abolyazid, A., Al-Musa, H. M., Awadallah, N. J., Faraheen, A., Khalil, S., & … Al-Musa, K. M. (2017). Hand hygiene knowledge of primary health care workers in Abha city, South Western Saudi Arabia. Journal of Family Medicine & Primary Care, 8(1), 136-140. doi:10.4103/2249-4863.214971
Maria Malliarou, R. N., Pavlos Sarafis, R. N., Sofia Zyga, R. N., & Constantinidis, T. C. (2013). The importance of nurses hands hygiene. International Journal of Caring Sciences, 6(3), 327.
Sharif, A., Arbabisarjou, A., Balouchi, A., Ahmadidarrehsima, S., & Kashani, H. H. (2016). Knowledge, Attitude, and Performance of Nurses toward Hand Hygiene in Hospitals. Global journal of health science, 8(8), 57.