Problem Statement
The healthcare environment is ironically not the safest of places as may be generally assumed by many people. This is because of numerous reasons but most of which revolve around the high-risk condition of the hospital environment to disease-carrying organisms. As a result, the healthcare environment instead of helping solve the problem increases the chances of patients on treatment dying or acquiring other infections by the virtue of being admitted to the hospital. In this regard, the study aims at determining how these diseases are transmitted to the patients from the hospital environment. In this case, the study by Kapil et al. (2015) aimed to determine if hand hygiene is an effective measure if recommended for the prevention of the spread of hospital-associated infections.
Hospital-acquired infections have been described as those illnesses that attack a patient while they are already under medical management. These infections can always be associated with various factors, some of which relate to medical procedures and others that relate to the patients directly in general sanitation measures. According to Boyce (2019), these hospital-acquired infections burden the healthcare system by increasing costs of care provision, especially in instances of recurrent and acute infections. In the United States healthcare environment, at least one out of every twenty to twenty-five hospitalized patients will be reported with an infection resulting from risks within their care environment.
The complications that arise with Healthcare-associated infections are real and can paralyze normal operations within a care setting. In light of these challenges, prompt and effective measures must be put in place to adequately address the present and potential future problems related to HIAs. As contained in a World Health Organization WHO, (2017) some interesting statistics as to the implementation of prevention measures against hospital-associated infections. In one study, it was revealed that the initiation of prevention mechanisms decreased the rates of HIA infections by up to 70% (Monegro et al., 2020). Such intervention measures can be used to save the total cost of care delivery to a greater extent in medical cost savings. Another study suggested that prevention measures should include appropriate healthcare providers’ education and training on proper HIA risk reduction mechanisms as part of best practices, for which hand hygiene is basic (Boyce, 2019). Hillier, (2020), notes that generally, healthcare organizations have made use of hand hygiene practices as a means of preventing hospital-associated infections. This practice has led to the reduction of disease cross-contamination and the limitation of the scope of resistance by microorganisms that spread diseases.
Theoretical/Conceptual Framework
This informative healthcare-associated infection study did not make use of a theoretical or conceptual framework of operation. However, the study aims at determining critical aspects of infection transfer through the hands, as such the risks of infections, routes of infection, measures of infection control, and the precautions that are needed to prevent risks of infections.
Research Methodology/Design
The study assumed an experimental study design, where the participants were grouped as either medical doctors, resident doctors, nurses, medical students, or hospital attendants as independent groups on whom the experiment was conducted.
Research Setting
The research was conducted in the intensive care unit of a tertiary health care facility attached to a Medical training institution in the Northern localities of the Republic of India. This setting was appropriate for the research study on hand hygiene for several reasons, one being that it is a very busy area of care where the possibility of infection transfer is high. Secondly, the area is opportune because most patients admitted to the intensive care units entirely depend on the care from healthcare providers.
Sampling Criteria
The inclusion criteria were non-biased and aimed at identifying medical practice personnel within the hospital, drawn from a population of sixty individuals, paired equally in six groups by their respective qualifications. The study excluded any healthcare personnel who were not primarily engaged with hygiene concerns within the hospitals. The exclusion included other support staff such as those in the administrative roles. The exclusion criteria also limited any healthcare providers working within the intensive care unit but who had no direct contact with patients and therefore had limited chances of spreading and collecting germs for the propulsion of HIAs.
The type of sampling in the study was convenience sampling, where the sample population was already known based on identified characteristics and their roles in the line of clinical care delivery. For instance, the sanitary attendants included were conveniently selected under their roles and responsibilities in the intensive care unit at the time of the study. The study utilized a total sample size of sixty, out of which forty-five were full-time clinical care staff and fifteen were medical students. The characteristic of the sample size is that they were all actively involved in the day to clinical activities of the hospital, with capabilities of spreading the hospital infections.
In the experimental group, each person involved in the study must have qualified for the study by conducting the correct hand hygiene practice steps using an alcohol-based hand sanitizer, after which hand impressions were collected before and after the practice. The participants then filled out a questionnaire to assess their perceptions about hand hygiene. The findings were then analyzed for results. The findings from the study report that proper hand cleanliness practices are approved ways of lowering the risks of infections in transient flora.
Implications for Future Research
Future research must emphasize healthcare providers’ interest in patients’ risks of acquiring hospital-related infections. In this research, awareness about hand hygiene was found to be generally high among all the care providers, but most of the subjects were only cognizant of hand hygiene post-taking care of patients. Therefore, future research must focus on enforcing hand washing as standard care operational criteria that need to happen almost constantly. Several studies have supported the place of hand hygiene in decreasing the transient flora in line with the current study analysis. In a systematic clinical study on hospital-acquired infections, study findings reported that the inclusion of systems tracking infection and those providing surveillance data over hand hygiene and other preventive measures have greater capabilities of reducing hospital-acquired infections (WHO, 2017).
Level of Evidence
This is a level IV evidence study aimed at assessing and correcting the risk factors for hospital-acquired infections in acute care facilities. It is level IV owing to the study design and case controls as a cohort study.
Conclusion
In conclusion, hand hygiene is a basic activity in healthcare disease prevention but which mostly is not adhered to in many care environments. Therefore, strict adherence to hand hygiene protocols could be beneficial in addressing the disease burden imposed on both patients and the healthcare system through hospital-acquired infections. Numerous policies and best practice guidelines are available to most care providers and areas aimed at controlling the rates of hospital-acquired infections. Nurses and all care providers must therefore adhere to these practice guidelines as a means of eradicating the unwarranted effects of hospital-associated infections. However, infection control education interventions should not only focus on the care providers. Patients admitted to the healthcare facilities also play a vital role in the spread of infections through poor hygiene practices, inadequate hand washing, and eating foods with unclean hands. Therefore patient education on infection prevention and control while undergoing treatment within the healthcare facilities is critical in determining the success and or failures of handwashing initiatives. The educational information could be aimed at addressing patient factors such as the need to avoid walking the wards barefoot to avoid catching infections in the process.
References
Boyce, J. M. (2019). Current issues in hand hygiene. American Journal of Infection Control, 47, A46-A52. Web.
Hillier M. D. (2020). Using effective hand hygiene practice to prevent and control infection. Nursing Standard, 35(5), 45–50. Web.
Monegro, A. F., Muppidi, V., & Regunath, H. (2020). Hospital acquired infections. In Stat Pearls. StatPearls Publishing.
World Health Organization. (2017). Evidence of hand hygiene as the building block for infection prevention and control: an extract from the systematic literature reviews undertaken as the background for the WHO guidelines on core components of infection prevention and control programmes at the national and acute health care facility level (No. WHO/HIS/SDS/2017.7). Web.
Kapil, R., Bhavsar, H. K., & Madan, M. (2015). Hand hygiene in reducing transient flora on the hands of healthcare workers: an educational intervention. Indian Journal of Medical Microbiology, 33(1), 125. Web.