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Hand Hygiene and Healthcare-Associated Infections


Healthcare-associated infections (HCAIs), including hospital-acquired infections (HAIs) and surgical site infections (SSIs), are health concerns that can be avoided with timely intervention. Arguably, one of the easiest and cost-effective solutions to tackle HCAIs is to promote compliance to hand hygiene standards by both patients and health workers. While HCAIs are a common issue in all types of medical facilities across the US, some types of settings are especially prone to giving rise to the described issue. It has been found that HCAIs were more prevalent in hospitals with inadequate organizational culture, environment, and educational patterns (Boev & Xia, 2015; Tajeddin et al., 2016). Aside from that, patients undergoing various types of care, such as cancer patients, are more susceptible to HCAIs (Sarani, Balouchi, Masinaeinezhad, & Ebrahimitabas, 2015). The gravity of the issue calls for an intervention plan that would be easy to follow for both nurses and patients. Therefore, the PICOT question for the present goes as follows: In patients receiving multiple types of care (P), will adherence to hand hygiene guidelines (I) as compared to the lack thereof (C) lead to lower HCAIs rates (O) at two months post-implementation?

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Evidence-Based Solution and Nursing Intervention

Adherence to hand hygiene standards is a recognized evidence-based solution to healthcare-associated infections. A systematic review conducted by Gould, Moralejo, Drey, Chudleigh, and Taljaard (2017) shows that out of 26 studies that investigated the validity of the practice, 14 found it to be effective. The question arises as to what elements the implementation of a new practice should entail becoming part of the usual workflow at a medical facility. As Gould et al. (2017) conclude in their review, the intervention should take place at multiple levels. The researchers mention the following elements that proved to be important in the studies reviewed:

  1. increasing the availability of alcohol-based hand rub;
  2. different types of education for staff;
  3. reminders (written and verbal);
  4. different types of performance feedback;
  5. administrative support;
  6. staff involvement.

In summation, a medical facility should have enough resources to ensure the availability of hygiene products. The administration of a facility should be well aware of the problem to partake in setting up new rules and regulations. As for the employees, they should be educated enough to be efficient health promoters. At all times, the organizational system should display interconnectivity: the managers should communicate with the employees and vice versa.

Nursing Practice, Patient Care, and Healthcare Agency

Integration into nursing practice should start with an education that can take a variety of forms. For some medical facilities, it might be more appropriate to use e-learning materials and simulation. Others may benefit more from lectures and workshops. A Gould et al. (2016) report, it is typical for hospitals to host in-house infection prevention teams or invite external consultants to educate the staff. Nurses should be aware of two things: optimal hygiene techniques and when they are to be applied. To deliver better patient care, a hospital might want to rearrange the working environment so that hygiene products are always at hand. It is also recommended to substitute liquid soap with an alcohol-based hand rub.

Healthcare agencies can and should be an important part of the intervention. Promoting the change cannot rely solely on health workers. Therefore, it is imperative to educate patients about hygiene so that they could manage their conditions better. Healthcare agencies can take the form of in-person or phone counseling in which a specialist explains hand hygiene standards. It should be noted that some people do not retain spoken words that well compared to the written word. Thus, one may want to print out informative leaflets and brochures that patients could use as a point of reference.


Boev, C., & Xia, Y. (2015). Nurse-physician collaboration and hospital-acquired infections in critical care. Critical Care Nurse, 35(2), 66–72. Web.

Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews, (9).

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Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabas, E. (2015). Knowledge, attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences. Global Journal of Health Science, 8(3), 193. Web.

Tajeddin, E., Rashidan, M., Razaghi, M., Javadi, S., Sherafat, S., & Alebouyeh, M., … Zali, M. (2016). The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections. Journal of Infection and Public Health, 9(1), 13-23. Web.

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