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Patients’ Hand Washing and Reducing Hospital-Acquired Infection

Background of Study/Summary

Hospital-acquired infections (HAIs) are some of the leading causes of prolonged stays, high costs of healthcare, and unprecedented mortality and morbidity rates among admitted patients. The clinical problem that led to the study was the role of observing hand hygiene among both patients and nurses in the prevention of HAIs. Before the study, it was not known what would be the effect of maintaining hand hygiene on HAIs, hence the research gap.

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The authors established the significance of the study by looking at the statistics of HAIs. According to Haverstick et al. (2017), one in every 25 patients in an acute care setting will have HAI at one point during their hospital stay. In 2011, 75,000 patients died from HAIs-related complications, while 722,000 patients were affected by this problem (Haverstick et al., 2017). These numbers underline the importance of the study.

The purpose of the study was to establish whether increasing access to hand hygiene products and educating patients could reduce cases of HAIs. The study focused particularly on infection cases of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile (Haverstick et al., 2017). The authors did not state the research questions directly, but they could be inferred from the study objectives. The research question would be – does increase access to hand hygiene products and educating patients to reduce cases of HAIs among hospitalized individuals? The purpose and research questions were related to the study problem as they all addressed the same issue of the role of observing hand hygiene in reducing HAIs.


The authors did not identify the benefits and risks of participation. Informed consent was not received from the participants. According to the authors, the hospital’s institutional review board gave the project exempt status. Therefore, informed consent was not needed because the project met the required criteria for quality improvement. It seems that the subjects participated in the study voluntarily because the project would lead to the prevention of HAIs, which would benefit all the patients. Therefore, even though the inclusion-exclusion criterion is not indicated, it is assumed that all patients would be interested in participating in this quality improvement project.

The hospital’s institutional review board approval was obtained. The major independent and dependent variables were not indicated. However, from the study design, independent variables would include observing hand hygiene among hospitalized patients and staff members, while dependent variables would be the rate of HAIs among the same population cohorts.

Data were collected using surveys. Before, the intervention, the participating staff members and patients were given paper-based 6-question surveys. Patients filled the surveys and returned them anonymously upon discharge. The survey questions were given at 4 stages – before intervention and 1, 2, and 3 months after the intervention. The survey questions sought to establish whether staff members educated patients on the need to observe hand hygiene.

HAI rates within the unit during the intervention period were recorded. The authors did not provide a rationale for using this method. However, it could be deduced that recording the number of HAIs during the intervention period would allow comparison with other rates before the project. The data was collected for 3 months.

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The data collection sequence was as follows – admitted patients were given 6-question surveys to indicate whether they were educated on the need to maintain hand hygiene. They were then given alcohol-based hand sanitizer to clean their hands when needed. Cases of HAIs were then recorded during the intervention period. The collected data were analyzed using SPSS version 21. Rates of HAIs were compared before and after the intervention. The authors did not discuss how the rigor of the process was assured. The researchers did not indicate the measures that they used to minimize the effects of their bias.


According to the authors’ interpretation of the findings, it was indicated that educating patients on the importance of hand hygiene and ensuring access to hand sanitizers reduced HAIs significantly. The results indicated that unit-specific HAI rates decreased by 70 percent in 19 months after the intervention. The findings are valid and an accurate reflection of reality because they confirm the claims made in the available literature review on the subject. Therefore, I have confidence in the findings.

The authors identified several limitations of the study. First, the sample size was small involving 39 participants. Additionally, the study was carried out in one unit of one hospital, and thus the results may not be generalizable in other set-ups. Besides, HAI rates after the intervention were compared with data obtained from the same unit before the project. Therefore, the control group was not randomized.

Patients’ learning capability was assessed on admission through brochures or verbally, and this aspect does not consider health literacy levels and learning needs of individual participants. The study was carried out in a fast-paced unit, and thus the effectiveness of staff members educating patients on the need for hand hygiene may not be ascertained and applicable in other set-ups. Finally, the survey responses from both staff members and patients may have been biased.

There was a coherent logic to the presentation of findings. The authors presented the results from the surveys first using data collected from the staff members and participating patients. Results from comparing pre and post-intervention periods were then presented. The findings apply to general nursing practice. Observing hand hygiene has been shown to reduce HAIs, and nurses should implement this practice for better patient outcomes. Further studies should focus on observing patients’ application of hand hygiene practices especially during critical times such as after visiting the restroom, before and after leaving the room, and before and after handling food.

Ethical Considerations

As mentioned earlier, the hospital’s institutional review board approved the study. The authors did not indicate whether patient privacy was protected. However, there were no ethical considerations or issues raised concerning the intervention as patients were not required to take any drugs or engage in practices that could affect their health negatively.


A thesis statement is important in any work because it guides the study and its congruity point to the success of the research. The thesis statement was proved as it was established that observing hand hygiene would reduce rates of HAIs among hospitalized patients. The study was carried out according to the guidelines that govern scientific inquiries. Besides, the findings are useful and applicable to nursing practice.

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HAIs are among the leading causes of death and morbidity among hospitalized patients, and thus nurses could use the findings of this study to reduce the rates of such infections. Some of the takeaway points include the importance of observing hand hygiene as a preventive measure of negative patient outcomes. Nurses should educate patients on the usefulness of using hand sanitizers when needed. Educating patients to improve their awareness of the need to observe hand hygiene, which in turn reduces cases of HAIs, thus improving care outcomes.


Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical Care Nurse, 37(3), e1-e8.

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