Hospital-Acquired Infections and Handwashing Intervention


Hospital-acquired infections (HAIs) are a prevalent cause of infection, disability, or death in hospitalized patients due to the presence of pathogens in healthcare settings. This results in decreased quality of care and negative outcomes. The PICOT statement for this project is: In ICU/post-op patients (P), what is the effect of a comprehensive hand-washing and antiseptic rule implementation for staff (I) on improving the rate of HAIs (O) compared with current procedures that simply recommend handwashing (C) within 3 months (T)?

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Evidence-Based Solution

Using hand hygiene with an alcohol-based antiseptic is the most widely recognized and effective method of preventing pathogen cross-transmission which leads to HAIs. This solution is inexpensive and requires little time from medical professionals. Patients in the ICU are at the greatest risk of infection due to common invasive medical procedures, creating open wounds, or weakening the immune system. The medical staff often transports pathogens from other wards, thus requiring stricter regulations and compliance for hand-hygiene and overall environment sterilization in the ICU (Tajeddin et al., 2016).

Nursing Intervention

Nurses are commonly the primary caretakers of patients and have the most frequent and direct physical contact while delivering care. However, despite widespread recognition and recommendations of hand hygiene, compliance remains low, ranging from as little as 30-40%. Multimodal interventions focusing on educational interventions for nurses, implementing stricter guidelines, and demonstrating role-model behavior, the average compliance rate increases to at least 61% (Baccolini et al., 2018). Tailored interventions based on the needs, activities, and settings of the medical facilities are significant to ensuring compliance.

The most common intervention types include awareness and education programs, monitoring and feedback, reminders through signage and notifications, and accountability for violation of policies if the nurse is surveyed (Currie, 2019). This level of pressure and implications for the hand-hygiene policy will increase compliance and lead to significant reductions in HAIs.

Patient Care

As mentioned, patients in the ICU are most susceptible to HAIs. Therefore, staff in the ICU should pay significant attention to hand hygiene during patient care. Particularly, treatment and bandaging of open wounds, sores, and post-operation incisions as well as changing catheters as these aspects of patient care in the ICU are most prone to infection. Following educational policies and guidelines, nurses must commit to handling hygiene before and after patient care, ensuring strict compliance in order for the intervention to be effective in addressing HAIs.

Health Care Agency

The Centers for Disease Control and Prevention (CDC) recommends and advocates improved hand hygiene in health care settings. They have recommended hand-washing techniques and suggest decontamination of hands with antiseptics consistently while in medical facilities. Hand hygiene must be practiced before and after interaction with patients as well as and medical procedures performed. The CDC has extensive guidelines in place regard hand hygiene for infection control practices which include an in-depth review of handwashing practices and promotes the value of multi-disciplinary hand-hygiene programs. This highlights the importance of antiseptic use and other issues of hygiene such as skin and nail care in order to reduce transmission of pathogens (Centers for Disease Control and Prevention, 2016).

Nursing Practice

Nurse practitioners can demonstrate proper hand hygiene practices and techniques, becoming role models for patients and co-workers. Based on the environmental theory by Nightingale, it is important to maintain a clean environment as it promotes improved health for patients. Nurses can ensure to advocate for awareness and knowledge regarding hand hygiene practices among health care professionals in acute settings (Mitchell, Boisvert, Wilson, & Hogan, 2017). Furthermore, in practice, nurses should abide by regulations of handwashing before and after every patient procedure as well as any other time there may be a potential for contamination. Despite it being time-consuming, it brings significant benefits to healthcare quality and safety in the long run.

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Baccolini, V., de Soccio, P., D’Egidio, V., Migliara, G., Marzuillo, C., De Vito, C., … Villari, P. (2018). Role of a multimodal intervention to promote hand hygiene compliance among healthcare workers. European Journal of Public Health, 28(4). Web.

Centers for Disease Control and Prevention. (2016). Hand hygiene guideline. Web.

Currie, D. M. (2019). Implementing guidelines to improve hand hygiene compliance. Web.

Mitchell, Hogan, Wilson, & Boisvert, E. (2017). Hand hygiene: A quality improvement project. BioMedical, 1(7), 1-4. Web.

Tajeddin, E., Rashidan, M., Razaghi, M., Javadi, S. S. S., Sherafat, S. J., Alebouyeh, M., … Zali, M. R. (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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StudyCorgi. (2021) 'Hospital-Acquired Infections and Handwashing Intervention'. 22 July.

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