Once again I searched for "hand hygiene" but this time I added "infection control "and "hospital acquired infections" to my search, and changed the dates to 2000 to 2010. The results which Internurse were of more relevance than Cinahl. So i reviewed several articles from Internurse which I though were the best, and then i went back to Cinahl and use the refined search terms to find some good articles to use and compare with Internurse. Using the refined search terms and the same advanced search settings which I had previously used which was relevant to assisting me in finding an answer to my question, I discovered that both Internurse and Cinahl, although quite difficult to use, brought up articles which were more or less stating the same things.
I wanted to know the amount of infections caught through healthcare were, and some of the reasons that this may be.
The first article which caught my attention was an Infection Control Survey by Gina Rollins (2008). She has included alot of statistics in her article, including a survey showing the main barriers to effective handwashing, which ranges from forgetfulness to believing gloves stop the spread of infection to ignorance of nurses believing that they will not catch any infections from particular patients. She also mentions that good hand hygiene is the single most effective way to reduce the spread of infectious agents onto hands.
I decided that before I continued reviewing the articles that I needed to know more about the possible infections, their severity and how they are spread from patient to nurse.
Rickard (2004) says that healthcare workers (HCW) can transmit microorganisms to patients, causing infections, which are known as healthcare associated infections (HAI). He also says that one third of HAI can be prevented by HCW adequately washing their hands. As was discussed in the previous article, it is becoming clear that there seems to be an ignorance regarding hand washing. One thing Rickard (2004) states are that there should be a culture change and hand washing facilities must become more accessible to (HCW).
I still felt that this was not answering my question. It has already become clear that the biggest effect of poor compliance of hand hygiene is the result of patients contracting infections, but i did not know to what extent these infections were and what they were. So I decided to look through more articles, and one thing I noticed is that healthcare acquired infections were also being called different things dependent on who was writing an article. So i went back to cinahl and decided to just put “acquired infections” OR “associated infections” into the search bars, so I could discover more about the infections.
Nancy Turner (2009) writes that between 2006 and 2008, Methicillin-resistant Staphylococcus Aureus (MRSA) and Clostridium Deficile were decreasing. Studies show that handwashing play a primary role in the decrease. She also goes on to mention that Urinary Tract infections and Lung infections were also decreasing due to good handwashing.
HAI affect 9% of patients and costs the NHS 180 million pounds per year in treatment says Emma Burnett (2008). Once again, the fact that the main perpetrator for HAI is non compliance of hand washing.
Helen Scott (2000) mentions that a report from the house of commons, reports that 100,000 cases of HAI are reported each year, and that 5000 of these result in death. She argues that the key to battling the amount of HAI is to educate all healthcare staff on the importance of good hand hygiene and the effects it can have.
It has become abundantly clear to me that the main effects of poor compliance of hand washing result in numerous infections, all of which are very serious and can result in death if undetected and not caught in time. It is also clear that the effects, although they have only been documented as physical in the articles which i have read, may also have a mental effect on patients, especially if they contract a HAI and must remain hospitalised for longer than was initially intended.
I have discovered that Evidence based practice is one of the most important things which all healthcare workers should be familiar with. It helps and aids in important decision making with being a credible and reliable source, usually consisting on plenty of research to show evidence in a particular subject.
In conclusion, this assignment has really opened my eyes to the importance of hand washing, and without evidence based practice and the research available to me, i would not have understood the severity of good hand washing completely. I am now aware that poor hand washing can, in the most severe cases, result in death
I have reviewed several different articles, and picked 5 from the list I had, and have come to the idea that the reasoning behind lack of hand washing between staff is usually because, during a shift, a nurse may feel it is necessary to skip hand washing procedure between dealing with patients to save time, which could be due to staffing levels. Recent studies show that in an average eight hour shift, one hour of a nurse’s time is taken up by hand washing. The alcohol hand rub, which has been introduced has been said to cut that hour by three quarters. The alcohol hand rub can be used up to three to four times in between a complete hand washing using soap and water, on hands which are not visibly soiled.
To me, it seems that staff are either not being educated properly, or may have little understanding of the severity of the absence of good hand hygiene, not just within hospitals, but also in any healthcare setting. I believe that the way forward would be to introduce glow and tell machines to every trust nationwide. I believe that this would make a lot of people realise just how easy it is to miss the microscopic bacteria which inhabit their hands.
Polit, Denise F, Beck, Cheryl Tatano. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice. 8th edition. Philadelphia. Lipincott Williams and Wilkins.
Rollins, Gina (2008). Curbing hospital-acquired infections. Hand hygiene compliance remains a goal unrealized. Materials Management in Health Care (MATER MANAGE HEALTH CARE), 2008 Jul; 17(7): 22-9
Rickard NA (2004) Hand hygiene: promoting compliance
among nurses and health workers. British Journal of Nursing, 2004,Vol 13, No 7
Turner, Nancy (2009) Hand Hygiene Focus Yields Visible Results, Materials MANAGEMENT IN HEALTH CARE November 2009 matmonmog.com
Burnett, Emma et al (2008) From theory to practice in learning about healthcare associated infections: Reliable assessment of final year medical students’ ability to reflect. University of Dundee, UK. Webpaper e157-e160
Scott, Helen (2000) British Journal of Nursing 2000 VOL 9 NO 22 pg 2264