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Hand Hygiene in Preventing Healthcare-Associated Infections

The proposed intervention for nurses was aimed at developing their skills in preventing and managing healthcare-associated infections (HAIs) to improve patient outcomes. While applying the qualitative methodology and case study research design, 20 nurses invited to participate in the project were interviewed before and after the implementation of the intervention. The results of data analysis related to the qualitative methodology and case study approach, as well as their discussion and limitations, will be presented in detail.

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Descriptive Data: Demographics

In the context of this study, 20 nurses were interviewed before the implementation stage to determine the main drivers for the appearance of HAIs in the selected hospital setting. After the implementation stage, the participants were interviewed to provide information on the effectiveness of the intervention to decrease and prevent HAIs. All the participants were females; 38% of nurses belonged to the age group of 31-40 years, and 31% belonged to the age group of 21-30 years.

Finally, 19% belonged to the age group of 51-60 years, and 12% of nurses belonged to the age group of 41-50 years. Furthermore, 46% of the participants were Registered Nurses, 30% were Advanced Practice Registered Nurses, and 24% were Nurse Practitioners.

Results of Content Analysis

The participants’ narratives were analyzed in the context of the content analysis approach with the help of open coding techniques and applying NVivo 10 as the software effective to determine themes in the nurses’ answers. Referring to the pre-intervention interviews, it was found out that the main drivers for the appearance of HAIs in hospital settings were inappropriate hand hygiene and not following infection-prevention procedures.

The first large theme (Hand Hygiene) covered 14 codes related to cleaning hands before contacting patients, using and not using alcohol-based liquids and sanitizers for cleaning hands, rubbing hands, using gloves, and others. The second large theme (Infection-Prevention Procedures) covered 21 codes related to the procedure of using catheters, hygiene during surgery, procedures, and protocols for making injections, and disinfection procedures. The participants also mentioned the strategies to prevent communicable diseases, protocols for using antibiotics, overuse of antibiotics in patients, and others.

After participating in the intervention oriented toward improving nurses’ knowledge and practice regarding the prevention of HAIs and the use of electronic cleanliness checking instrument, nurses answered another set of questions. The themes identified with the help of NVivo 10 included Training Sessions for Nurses, Instruments to Improve Hygiene, Guidelines, and Protocols for Disinfection.

Discussing Training Sessions for Nurses, the participants used eight codes, referring to the importance of regular training and the role of evidence-based practice. Eleven codes were associated with the theme Instruments to Improve Hygiene: the use of checking instruments, availability of sanitizers, and applied disinfection procedures among others. Five codes were determined about Guidelines and Protocols for Disinfection, accentuating the importance of following protocols and norms strictly to prevent HAIs.

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Discussion of Results

The collected findings are in line with recent research in the field of HAIs. The participants of this project accentuated the role of hand hygiene practices in developing and preventing HAIs in hospitals. In their study, Sickbert-Bennett et al. (2016) also noted that improved hand hygiene in healthcare providers could lead to decreasing the rate of infections in hospitals. The researchers found a positive correlation between improving hand hygiene practices and reducing HAI rates.

Percival, Suleman, Vuotto, and Donelli (2015) studied the importance of preventing biofilms on medical devices, and they also determined the significance of following infection-prevention procedures and hygiene protocols to address HAIs. The study’s results are also aligned with Haque, Sartelli, McKimm, and Bakar’s (2018) findings on the significance of cleaning hands and educational interventions for reducing HAIs and associated morbidity. Therefore, the results of this project are credible as they are supported by previous studies’ findings.


The limitations of this study are associated with the applied methodology. The qualitative methodology used in this research limits the generalizability of the findings. For future research, it will be appropriate to conduct a quantitative or experimental study on the relationship between the applied intervention and changes in HAI rates in a hospital setting. In addition, a limited sample size appropriate for a qualitative study is also a limitation that can be addressed by using a large representative sample for a quantitative project.


As a result of conducting the study, it is important to state that the main triggers for HAIs in hospital settings include inappropriate hand hygiene, not using sanitizers, and ignoring infection-prevention procedures and disinfection. HAIs can be spread when nurses do not use gloves, do not clean hands carefully, ignore rules when using catheters, and making injections. In addition, it has been found out that certain educational interventions and training for nurses, as well as the application of tools to control disinfection, are perceived as effective steps to address HAIs. Nurses need to be educated and trained regarding hygiene and infection-prevention procedures, along with norms, standards, and rules for disinfection, to prevent the spread of HAIs.


Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Health care-associated infections–An overview. Infection and Drug Resistance, 11, 2321-2333.

Percival, S. L., Suleman, L., Vuotto, C., & Donelli, G. (2015). Healthcare-associated infections, medical devices and biofilms: Risk, tolerance and control. Journal of Medical Microbiology, 64(4), 323-334.

Sickbert-Bennett, E. E., DiBiase, L. M., Willis, T. M. S., Wolak, E. S., Weber, D. J., & Rutala, W. A. (2016). Reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices. Emerging Infectious Diseases, 22(9), 1628-1630.

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