Hygiene Evidence Based Practice In Health Care
Question:
Answer:
According to World Health Organization (2018), it is very important for the healthcare workers to maintain their hygiene and sanitation to control the spread of infectious associations as well as to limit the antimicrobial resistance. The WHO data reveals that each year millions of people get affected with nosocomial or healthcare associated infections while their hospital stay due to poor sanitation and hygiene and suffers from prolonged hospital stay, additional cost due to infection, long term disability, microbial resistance and even may lead to sudden death as well (Septimus et al., 2014). Australia also suffers from this concern as more than 150,000 people suffers from hospital acquired infection every year and suffers from infections such as urinary tract infection, respiratory and surgical site infection (Allegranzi, Sax & Pittet, 2013). In this assignment, the importance of hand hygiene in healthcare settings will be discussed with the means of healthcare workers. Further using evidences from recent literatures different examples will be provided in which poor hand hygiene leads patient’s complications. Finally, the benefits of maintaining hand hygiene and means through which it can be maintained will be described.
While describing the hand hygiene, the normal flora of hand should be discussed. There are two kinds of flora residing in the superficial cells and superficial layers of human hand, such as the resident flora and the transient flora. The resident flora resides under the stratum corneum and the transient flora resides under the superficial layers of skin and hence, it is removable using proper hand hygiene techniques. This transient flora is acquired by different healthcare professionals while handling patients in less hygiene situations and hence, these are the organisms that are associated with hospital acquired infections. According to Harris et al., (2013), it has been observed that the Methicillin resistant Staphylococcus aureus or MRSA is the primary microorganism that is colonized on the hands of healthcare professionals with other bacteria like vancomycin resistant Enterococcus, clostridium, Candida and so on. Harris et al., (2013) determined that these bacteria are able to successfully survive and colonize on human skin for 150 hours and is able to contaminate different nursing equipment and apparels such as their gown, patient’s bed, furniture in the hospital facility. This was the reason the World Health Organization (2018) reinforced the practice of hand hygiene in healthcare professionals with “SAVE LIVES: clean your hands” movement in which the primary focus was on the ‘5 movements of the Hand Hygiene’ so that while dealing with infections and in direct contact with critically ill patients the hospital acquired infections can be stopped or reduced to controllable rates.
To understand the effects of hand hygiene in reducing infection related cases in patients, recent research literatures should be utilized. In a research conducted by Duerden et al., (2015), researchers were trying to find out the impact of the WHO driven clean your hand campaign on the hospitals ability to control hospital-acquired infections. For this purpose, 187 hospitals of England and Wales were chosen and the rates of hospital-acquired infections from July 2004 to June 2008 were assessed. It was seen that all the hospitals had installed alcohol hand rubs and hand sanitation equipment as well as the organization used to carry out monthly audits so that hygiene can be maintained (Septimus et al., 2014). They found that all the hospitals were conducting audits to demonstrate the rate of hospital acquired infection and after the completion of fur years the MRSA and VRE related infections decreased to noticeable extent (Duerden et al., 2015). Inanother literature, the impact of hand hygiene was assessed with respect of occurrence of MRSA and the objective was to assess the impact of multimodal approach in medical wards to comply with the hand hygiene (Zingg et al., 2015). The researchers conducted the study in three critical control wards and the use of Alcohol based hand rub (AHR) was aligned with the incidents of MRSA infections. After 1 year of assessment it was found that using proper hand hygiene routines, the facility was able to decrease the rates of hand hygiene acquired disease by 54.3% (Manian, Griesnauer & Bryant, 2013).
Therefore, from above literatures, the importance of hand hygiene on healthcare of patients can be understood. However, the timing of hand hygiene should be properly discussed with the health care professionals such as before beginning and end of the shift, during application of different interventions on the same patient, prior to serving food, water or medication to the patient (Loveday et al., 2014). Further hand hygiene should also be used after assisting in activities of daily life to the patient and proving invasive care to the patient. Further, there are several rules set by the WHO that should be implemented while cleansing hands such as usage of soaps and water, usage of safety gloves to eliminate microbes’ colonization on hand surface and increase the level of skin tolerability (Climo et al., 2013). Despite of these, sometimes health hygiene experts are unable to follow the hand hygiene practices because maximum of the healthcare facilities do not stick to the WHO recommended hand hygiene practices as well as individual attitude and belief towards hand hygiene also varies among the health experts (Loveday et al., 2014). Therefore, where some health experts follow the complete health hygiene practices, others are unable to maintain the minimal sanitation while serving their patients and leads them to suffer from hospital acquired infections. In the Australian healthcare settings, the majority of hospital acquired infection is the urinary tract infection occurs in maximum number of patients, which is followed by the surgical site infection. Death due to hospital acquired infection is around 20% in Australia (Climo et al., 2013).
While concluding the assignment it should be mentioned that hand related infections are very common in today’s world as almost everyone is affected with common cold, fever and other common diseases that spread through hand. However, in healthcare settings, not maintaining hand hygiene can lead to disorders that can be life-threatening or can lead to permanent or temporary disability. In this assignment, using three literatures the impact of hand hygiene on patient’s wellbeing was discussed. Further, using the WHO guidelines, the method, and timing of hand hygiene was discussed that the healthcare professionals of each healthcare facility should follow.
References
Allegranzi, B., Sax, H., & Pittet, D. (2013). Hand hygiene and healthcare system change within multi-modal promotion: a narrative review. Journal of Hospital Infection, Volume. 83, pp. S3-S10. DOI: https://doi.org/10.1016/S0195-6701(13)60003-1
Climo, M. W., Yokoe, D. S., Warren, D. K., Perl, T. M., Bolon, M., Herwaldt, L. A., … & Wong, E. S. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. New England Journal of Medicine, vol. 368, issue 6, pp 533-542.DOI: 10.1056/NEJMoa1113849
Duerden, B., Fry, C., Johnson, A. P., & Wilcox, M. H. (2015, March). The control of methicillin-resistant Staphylococcus aureus blood stream infections in England. In Open forum infectious diseases (Vol. 2, No. 2, p. ofv035). Oxford University Press. DOI: https://doi.org/10.1093/ofid/ofv035
Harris, A. D., Pineles, L., Belton, B., Johnson, J. K., Shardell, M., Loeb, M., … & Hall, K. K. (2013). Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial. Jama, Vol. 310, issue 15, pp. 1571-1580.doi:10.1001/jama.2013.277815
Loveday, H. P., Wilson, J., Pratt, R. J., Golsorkhi, M., Tingle, A., Bak, A., … & Wilcox, M. (2014). epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection, Vol. 86, PP. S1-S70. DOI: https://doi.org/10.1016/S0195-6701(13)60012-2
Manian, F. A., Griesnauer, S., & Bryant, A. (2013). Implementation of hospital-wide enhanced terminal cleaning of targeted patient rooms and its impact on endemic Clostridium difficile infection rates. American journal of infection control, vol. 41, issue 6, pp. 537-541. DOI: https://doi.org/10.1016/j.ajic.2012.06.014
Salama, M. F., Jamal, W. Y., Al Mousa, H., Al-AbdulGhani, K. A., & Rotimi, V. O. (2013). The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital. Journal of infection and public health, vol. 6, issue 1, pp. 27-34.DOI: https://doi.org/10.1016/j.jiph.2012.09.014
Septimus, E., Weinstein, R. A., Perl, T. M., Goldmann, D. A., & Yokoe, D. S. (2014). Approaches for preventing healthcare-associated infections: go long or go wide?. Infection Control & Hospital Epidemiology, Vol. 35, issue 7, pp. 797-801. DOI:https://doi.org/10.1086/676535
Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., … & Pittet, D. (2015). Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, vol. 15, issue. 2, pp. 212-224. DOI: https://doi.org/10.1016/S1473-3099(14)70854-0
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