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Handwashing Noncompliance: PICOT Statement

Personal hygiene begins with washing hands. Florence Nightingale, who was the pioneer of standard hygienic procedures in healthcare, has noticed the importance of handwashing in doctors and patients as a means of improving outcomes (American Nurses Association, 2015). Handwashing is considered standard protocol in most, if not all, modern-day healthcare facilities. However, this important procedure is often overlooked because of negligence. The purpose of this intervention is to reduce on-site infections and complications as a result of handwashing non-compliance.

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PICOT Question

The PICOT question for this proposal is as follows: In the surgical services units (P), does handwashing education sessions for health workers (I), compared with handwashing non-compliance among physicians, staff, and visitors (C), decrease the frequency of hospital infections (O), in 6 months (T)?

Evidence-Based Solution

Enforcing compliance and facilitating understanding of the importance of handwashing in clinical settings, especially in surgical units and long-term care facilities, is the proposed solution to the problem. The importance of handwashing is supported by empirical data and academic research. According to Sickbert-Bennett et al. (2016), personal hygiene is directly related to the chances of infection. The approximate correlation is three to five, meaning that for every 5% increase in frequency and quality of handwashing among staff, there is a 3% reduction in hospital-acquired infections (Sickbert-Bennett et al., 2016).

These findings are supported by Kingston, O’Connel, and Dunne (2016), who found a positive association between handwashing and infection rates across numerous studies dedicated to measuring and improving handwashing compliance.

Nursing Intervention

While most nurses typically sterilize their hands before conducting sensitive operations, the majority of them do not do so during day-to-day services that do not require direct patient contact. A lack of comfortable access to water sources is the problem. The proposed intervention involves utilizing portable and mobile handwashing stations, accessible to nurses and patients alike. This intervention is supported by Bennett et al. (2015), who found it to be very effective and cost-efficient.

Patient Care

The proposed intervention will have a significant impact on the quality of patient care. It will reduce the number of hospital-acquired infections, especially in surgical units, intensive care units, and long-term care facilities. Mobile handwashing stations will provide convenient sterilization points for nurses and patients alike, thus resulting in better healthcare outcomes.

Healthcare Agency

According to American Nurses Association (2015), one of the primary roles of healthcare providers is to ensure the highest possible quality of care and to make responsible decisions to benefit the patient’s health. This intervention falls under healthcare agency, as rigorous and frequent handwashing is one of their duties as healthcare providers. In addition, the intervention enables patient agency, as they would be able to influence their healthcare outcomes by performing hand sterilization procedures.

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Nursing Practice

The proposed intervention will have a strong impact on the existing nursing practices. According to Bennett et al. (2015), the percentage of handwashing compliance across the majority of hospitals that have participated in related studies is 34%, which is extremely low. This intervention will provide education and training to patients and nurses alike, as in the majority of the cases nurses disregard handwashing as “unnecessary.” In addition to instilling a new sense of purpose and an understanding of the importance of handwashing, the study will add to the existing body of knowledge of how such a simple and cost-efficient project could drastically reduce hospital infection rates.


American Nurses Association. (2015). Risk and responsibility on providing nursing care. Web.

Bennett, S. D., Otieno, R., Ayers, T. L., Odhiambo, A., Faith, S. H., & Quick, R. (2015). Acceptability and use of portable drinking water and hand washing stations in health care facilities and their impact on patient hygiene practices, Western Kenya. PLOS ONE, 10(5), e0126916. Web.

Kingston, L., O’Connell, N. H., & Dunne, C. P. (2016). Hand hygiene-related clinical trials reported since 2010: A systematic review. Journal of Hospital Infection, 92(4), 309–320. Web.

Sickbert-Bennett, E. E., Dibiase, L. M., Willis, T. M., 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. Web.

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