NRS328 Professional Nursing Evidence Informed Practice

Introduction

A literature review is an in-depth process of reviewing article, book and journals that helps in gathering knowledge about a certain subject matter. Literature has a significance role in conducting empirical researches that includes present knowledge and theoretical as well as methodological contribution from peer scholars on a specific topic (Hamari, Koivisto, & Sarsa, 2014). The present literature review is on how an alcohol based hand rub is effective in the healthcare. An important measure of reducing infections through transmission among the health worker is using of medical solutions for hand hygiene (Maher, Eslami & Ali-Mohammadzadeh, 2016). The use of hand rubs in the healthcare areas has been an important measure (Boyce et al., 2017). Washing hands with water and soap is surely the best method of removing germs and microbes however, it is not always easily available in the surrounding. The paper highlights the effectiveness of the alcohol based hand rubs and the ways it can be used in the healthcare for the patients.

Aims and objectives:

This paper focused on the effectiveness of alcohol based hand rubs. The paper also provides knowledge about the alcohol based hands rub is and the advantages of using the alcohol based hand rubs.

The main objectives of the study are-

• To indentify the effectiveness of alcohol based hand rub.
• To understand the using the alcohol based hand rubs over soap and water.

Methods:

The present study includes knowledge obtained from library and classrooms. Also, the source of conducting the present study is the database obtained from Google Scholar and PubMed. The study has also included CINAHL for obtaining database. The inclusion criteria for selecting the articles are the articles published in English language only, published within the year of 2010 to 2018 and the articles that are found in full text format. The articles not fulfilling these three criteria are the considered excluding factors.

Result:

The common thing between all the three articles is the significance that has been given to hand washing. There has been increase in the awareness of hand hygiene however, there is also very limited efforts in comparison to the magnitude of the problem.  Hand hygiene is one of the vital parts that are required to reduce transmission of healthcare associated microorganism. Healthcare associated infections tend to get more attention from healthcare workers, patients and regulatory bodies (Jabbar et al., 2010). The problem is not only popular for the diseases it can cause or the cost of treatment one has to bear but also for the fact that it is easily preventable. Therefore, hand hygiene is considered as one of the basic and yet significant element of infection control activity. All the three articles have emphasized on the importance of hand hygiene (Kundrapu et al., 2014). Effective hand hygiene proves to a beneficial method of substantially decrease contaminated infections among the healthcare workers. Along with endemic infections a healthy hand hygiene program is useful in decreasing the emergence of pathogens that are antibiotic resistant (Yeung, Tam & Wong, 2011).

Various studies has been conducted on a trial of hand soaps with water, hand washes and alcohol hand rubs which determines the product capacity of removing clostridium difficile spore from patient’s hands. there are two studies that have conducted for same reason however they are different in their perspective. Clostridium difficile has always been a major issue for hand hygiene as the spores are found to be resistant to products that are alcohol based. The process of hand washing with soap is more effecting when done by hand wash or the soaps and water. The random trial done on a group of patients found that patient’s hands that were contaminated with the clostridium difficile spores is benefitted by the soap and water washing (Kundrapu et al., 2014). However, another study that was conducted for the same purpose shows that the usage of alcohol based hand rubs is efficient in removing clostridium difficile. The study also says that further studies are required to investigate therefore relying solely on the alcohol based hand rubs is not adequate to decontaminate hands. The viable spores will have the potential of spreading to the hands of the health workers as well or to other patients (Jabbar et al., 2010). Washing with water and soaps physically rinse off the spore from the patient’s hands. The alcohol hand rub failed reduce the burden of spores and the frequency of positive culture that was possible by soaps and water. (Kundrapu et al., 2014). The alcohol based hand rubs can be used to contaminate hands of the patients however relying solely on it is not advisable (Jabbar et al., 2010).

Among all the articles only the article by Yeung, Tam & Wong reflects the reason why alcohol based hand rub is preferred more than the soap and water. The healthy hand hygienic program includes washing of hands with soaps and water, hand washes and the alcohol based hand rubs. The alcohol based hand rubs are one of the most used method in the healthcare workforce. The study was conducted to see the usage of pocket-sized container alcohol based hand rubs among the elderly residents. The study finds the usage of the alcohol based hand rub usage has the tendency to increase where the usage of soap and water has the tendency to slow down. The process of washing hand is not preferred since the convenient method is to use the pocket size container of the alcohol based hand rubs. The result shows that the use of alcohol based hand rub is more efficient in bringing the healthy hand hygiene culture. The use of soaps and water is reduced and replaced by the usage of the alcohol based hand rubs. The study needed further investigation as well to find the effect of hand hygiene on self-limiting infections or minor infections (Yeung, Tam & Wong, 2011).

Findings:

All the three articles have given insight about the effectiveness of alcohol based hand rubs. According to the reviewed articles it can be stated that the alcohol based hand rubs are  not as much efficient as the water and soaps which have been the traditional practice of maintaining the hygiene of hands. The articles explain that the patients and the workers are concerned about the positive impact of the effective hand washing however the measure of performing the action is guided by the convenience. The pocket-size alcohol based rub is easier to use and therefore it is mostly chosen by the healthcare workers and the patients.

Relevance to Clinical Practice:

The finding tells that the better way of maintain the hygiene is the washing hand with soaps and waters than the alcohol based hand rub (Halm & Sandau, 2018). The alcohol based hand rubs are not incapable of removing the pathogens; it has proven to be efficient (Managan, 2015). The usage of alcohol based hand rubs can be continued as it does help in cleaning the hands effectively however, having infections such as clostridium difficile and such infections will require a healthier habit. The healthcare centre can proceed to use the alcohol based hand rubs since the second study shows the process of washing hand decreases with the time when the usage of the convenient method is used more often (Blenkharn & Smales, 2017). This process of adapting alcohol based hand rub may require little extra investment for the healthcare however; it will evolve the hand hygiene culture which will reduce the contaminated infections. There needs to be further investigations on creating hand rubs that would be totally satisfactory and also soft antibiotic towels for the emergency purposes in the medical for the healthcare workers.

Conclusion:

Effective hand washing ensures lesser contaminated environment therefore the hand washing habit is frequently seen as one of the main element of healthy habit (Foddai, Grant & Dean, 2016). The washing of hands with soaps and water is one of the best ways to eliminate the chances infections caused by contaminating pathogens (Chraïti, & Widmer, 2017). However, the alcohol based hand rubs has replaced the soaps and water method of cleansing hands and it is now used widely. Reviewing the data of the peer scholars it s evident that usage of water and soaps is the efficient way however, the alcohol based hand rubs are slightly lesser inefficient compared to the soaps and water. Since the alcohol based hand rubs are convenient it is used widely by the healthcare and the patients to ensure hand’s hygiene. Therefore, the alcohol based hand rubs are effective to a great extend and since it is a convenient method it should continue using it.

Reference:

Blenkharn, J. I., & Smales, C. (2017). Handwash product and handwash technique are equally important. Journal of Hospital Infection, 96(3), 298-299.

Boyce, J. M., Polgreen, P. M., Monsalve, M., Macinga, D. R., & Arbogast, J. W. (2017). Frequency of use of alcohol-based hand rubs by nurses: a systematic review. infection control & hospital epidemiology, 38(2), 189-195.

Chraïti, M. N., & Widmer, A. F. (2017). Hand hygiene technique. Hand hygiene: a handbook for medical professionals, 70-75.

Foddai, A. C., Grant, I. R., & Dean, M. (2016). Efficacy of instant hand sanitizers against foodborne pathogens compared with hand washing with soap and water in food preparation settings: a systematic review. Journal of food protection, 79(6), 1040-1054.

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs Handwashing. American Journal of Critical Care, 27(4), 334-337.

Hamari, J., Koivisto, J., & Sarsa, H. (2014, January). Does gamification work?–a literature review of empirical studies on gamification. In 2014 47th Hawaii international conference on system sciences (HICSS) (pp. 3025-3034). IEEE.

Jabbar, U., Leischner, J., Kasper, D., Gerber, R., Sambol, S. P., Parada, J. P., … & Gerding, D. N. (2010). Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infection Control & Hospital Epidemiology, 31(6), 565-570.

Maher, A., Eslami, Z., & Ali-Mohammadzadeh, K. (2016). Effect of Hand Hygiene Education on Knowledge, Attitude and Practice of NICU and Pediatric Staff in Zanjan Hospitals. Human Resource Management, 3(2), 35-43.

Managan, K. (2015). “One Hand Washes the Other”: Social Capital and the Politics of Leisure in Guadeloupean Associations. French Politics, Culture & Society, 33(3), 74-94.

Kundrapu, S., Sunkesula, V., Jury, I., Deshpande, A., & Donskey, C. J. (2014). A randomized trial of soap and water hand wash versus alcohol hand rub for removal of Clostridium difficile spores from hands of patients. Infection Control & Hospital Epidemiology, 35(2), 204-206.

Yeung, W. K., Tam, W. S. W., & Wong, T. W. (2011). Clustered randomized controlled trial of a hand hygiene intervention involving pocket-sized containers of alcohol-based hand rub for the control of infections in long-term care facilities. Infection Control & Hospital Epidemiology, 32(1), 67-76.