Introduction: One of the most important step to prevent hospital acquired infections is through effective hand hygiene. The research has shown that different Healthcare-Associated Infections(HAIs) spread through healthcare workers carrying micro-organisms on their hands. Hospital acquired infections are preventable through effective hand hygiene. The topic I have chosen today is hand hygiene. The purpose/aim of my topic is to study the importance of hand hygiene, to prevent cross infections in hospitals and the factors affecting compliance of healthcare workers for hand hygiene and recommendations for improvement.
Importance of Hand Hygiene
Hand Hygiene is a term used for cleaning hand to remove microorganisms or any dirt. It is considered as one of the easiest way to prevent infection in healthcare. Various studies has proved the relationship between good hand hygiene habits , reduced infection , and cross -transmission . Healthcare workers not only acquire infection by touching patient directly but also through touching the patient environment such as touching patient charts at nurse’s station . Hand Hygiene must be performed at particular moments while dealing with the patient either with soap and water if it has visible soil on hands or with alcohol based hand rub if it does not have visible soil. The five moments when hand hygiene must be performed are before and after touching patient , before and after doing any task , after touching the objects around the patient . HAIs complicate the patient’s condition in hospitals. There are many diseases that can spread from hand contact like diarrhoea, flu and other intestinal problems that can affect immune system of especially old people and young children. Effective infection control measures such as hand hygiene, helps to control transmission of infection and helps in early recovery of patients, which makes early discharge of patients. This is economic and cut down cost spent on medical procedures and money could be spent for research purposes . There are other factors that should be considered by health care workers to prevent spreading of bacteria on hands like washing hands before and after using gloves, no use of nail polish , keeping nails short , wearing short sleeved shirts , avoiding wearing jewelleries like chains , watches , bracelets etc.
Reasons for Non-Compliance and Recommendations
Nurses are the first person who come in contact with patients and its necessary for them to perform hand hygiene as it is the only most important measure to control infection. Despite the regulations, still hand hygiene is not up to the mark among health workers. There are many factors affecting compliance of healthcare workers. Following are some examples like lack of staffing , excessive work load on nurses and healthcare workers, is one of the most common reason for non-compliance. Other reasons for non-compliance are that the hand hygiene products are not placed at convenient location , health workers forget to follow infection control due to busy schedule or do not have the habit to do so. Some health workers might have allergies to chemicals causing skin problems or skin irritation as using chemical every day can damage their skin. Sometimes, lack of resources like dispenser is not filled ,as a result nurses are not able to follow proper hand hygiene . Many times nurses prioritise patient care more then hand hygiene due to their busy schedule , find it difficult to access location of the sink and so on.
Researchers have suggested various recommendations to improve hand hygiene compliance like organising frequent meetings for staff members to remind their responsibility for patients, placing alcohol based hand rub at convenient places so that it can be used as needed by nurses , patients , family and friends who so ever visit the hospital. It should be the responsibility of staff members to look after refilling the resources like dispensers etc working in that particular area. Other recommendations to improve compliance could be conducting staff and visitor survey on hand hygiene. Conducting education sessions on various strategies to improve hand hygiene at hospitals, providing brochures on different techniques, moments and methods to patients and families, to make them understand the importance could help to improve compliance. Monthly staff meetings should be organised to provide feedback on improvement and encourage them to remind the visitors and multidisciplinary team to follow the standards. Frequent audits to check staff hand washing techniques and their current knowledge on infection control, would also help in improving compliance. Initiating campaigns to spread knowledge about hand hygiene among community would be beneficial as well.
Conclusion: The conclusion of this essay is that, that many HAIs are spreading among health carers, patients and visitors is due to microorganisms on their hands which can be prevented by following WHO’s recommendations on effective hand hygiene techniques and moments.
Hand hygiene is one of the best and cheapest method to prevent cross contamination. It could also help to cut down the cost spending on hospital infrastructure, staffing and medicines etc due to less nosocomial infections and early discharge. Hands can be washed either using alcohol gel hand rub or soap and water for visibly dirty hands and it is less time consuming. However, there is still non-compliance for following hand hygiene practices among healthcare workers, patients and families. There are many reasons for it. Work load and lack of education is one of the common factors responsible for non-compliance. Instead of having knowledge about infection control, nurses and other health care workers are non-compliant to follow hand hygiene is because of understaffing and poor staff and patient ratio. Sometimes, health care workers become negligent for using hand rub when it is not easily accessible. Most of the time, they are not aware that hand washing is necessary even when they are wearing gloves. Some healthcare workers who are allergic to chemicals, are reluctant to use hand rubs, soaps as it can cause many skin problems such as dermatitis. Compliance could be achieved through educating healthcare workers, patients and visitors. Audits could help as well for achieving hand hygiene compliance.