Hand Hygiene in Hospital Environments

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Table of Contents

Introduction
How Infections Spread
Reducing or Preventing the Spread of HCAIs
Strategies for Boosting Hand Hygiene Compliance
Conclusion
References

Introduction

People operating within healthcare settings are subjected to a high risk of contracting infectious ailments. The issue of Hospital-Acquired Infections (HAIs) is an international healthcare problem that compromises patients’ safety. According to Yallew, Kumie, and Yehuala (2017), more than 100 million cases of HAIs have so far been reported globally. This situation reveals the existence of inadequate frameworks or strategies for encouraging hygienic interactions between people in healthcare settings. Although various mechanisms such as covering sneezes and coughs, ensuring that people are vaccinated accordingly, and using tissues and hand-cleaning materials, among others, have been tested and proven sufficient in preventing HAIs, this paper narrows down to hand hygiene, which is deemed the most effective method of dealing with infections in hospital environments. Despite people’s awareness of the need for disinfecting their hands, many of them have been non-abiding. Hence, this paper also examines various approaches that can be adopted to enhance hand hygiene compliance within various hospital environments.

How Infections Spread

To appreciate the role of hand hygiene in eliminating the spread of infections within healthcare surroundings, it is crucial to examine various mechanisms that enhance the spread of germs. Although the article by the Centres for Disease Control and Prevention (2017) does not explicitly mention the way people facilitate the spread of pathogens through their hands, it is apparent that these body organs are highly utilised in dealing with what enters or leaves the human body. Hence, hands act as the link between the source of germs and the vulnerable person. In particular, they facilitate the pathogen transmission process (Centres for Disease Control and Prevention, 2017). It is imperative to mention that germs in the form of virus, bacteria, or fungi rely on a particular medium to relocate from the source to the vulnerable individual (Baltes, Akpinar, Inankur, & Yin, 2017). People, surroundings, and medical devices fuel the spread of disease-causing particles in health centres.

However, according to the Centres for Disease Control and Prevention (2017), such germs move from the source to the susceptible individual via “contact (i.e., touching), sprays and splashes, inhalation, and sharps injuries” (para. 3). In line with studies by Opara, Alex-Hart, and Okari (2017), the World Health Organisation (2018), and Robinson et al. (2016), dirty hands contribute hugely to the spread of germs via the above methods because they directly or indirectly facilitate people’s contact with susceptible individuals or disease-carrying objects.

The article by the Centres for Disease Control and Prevention (2017) confirms this claim by revealing the extent to which medical practitioners’ hands are exposed to pathogens following their continued touching of different health devices, especially those that are meant for testing patients’ well-being through samples, including urine or blood among others. This situation has been linked to fatalities. According to the research by Magill, Dumyati, Ray, and Fridkin (2015), more than 29000 cases of death have been reported to result from hospital-related infections in America. As a result, following the global nature of healthcare-associated infections (HCAIs), it is vital to examine some strategies that have been proposed to deal with this issue, particularly by minimising people’s exposure to germs.

Reducing or Preventing the Spread of HCAIs

Medical facilities have implemented various measures to help in dealing with the issue of healthcare-associated infections. For instance, the article by Chen, Lin, Jiang, and Chen (2014) addresses the concept of covering one’s coughs and sneezes. Deploying this measure can be fruitful because it helps to lower the rate of spreading airborne diseases. Because of the diverse nature of people who visit various health centres seeking medical services, it is possible that a particular person’s exposure to germs through uncontrolled coughing or sneezing may worsen not only other patients’ well-being but also subject healthy individuals to the risk of contracting viral, bacterial, or fungal diseases (World Health Organisation, 2018). The implication here is that failing to cover one’s coughs and sneezes may subject an entire hospital and, consequently, the society to preventable airborne diseases (Centres for Disease Control and Prevention, 2017). The use of surgical and N95 covers has been tested and confirmed efficient in getting rid of exhaled germs (Chen et al., 2014).

Other HCAIs arise from people’s ignorance to take vaccinations as recommended before interacting with other individuals within healthcare facilities. Many diseases, such as measles and tuberculosis, are highly communicable. Hence, healthcare facilities can deploy measures such as screening patients promptly for these ailments as a way of ensuring that other parties are not exposed to the risk of getting new infections. Consequently, those who are found to be suffering from such diseases can be immunised accordingly and barred from interacting with other patients within hospital settings. The article by Sifferlin (2014) paints an interesting picture whereby the screening of American-based kindergarten-level learners in the academic period of 2012-2013 revealed that 9 in every 10 students had been immunised as recommended, hence minimising chances of spreading transmittable ailments. Simons, Unger, Lopez, and Kohn’s (2015) study gives similar findings whereby the U.S. Advisory Commission on Immunisation requires all juveniles to undergo appropriate vaccinations to avoid the spread of deadly viral pathogens.

Another method of reducing or preventing the spread of HCAIs entails adhering to the set healthcare guidelines regarding the handling of blood samples or other infected items within hospital settings. This measure primarily focuses on medical practitioners who have to test patients’ health status using samples such as urine or blood. Once such experiments are done, failure to dispose of already-used tools or contents being analysed may pave the way for the spread of infectious diseases to not only themselves but also patients, their families, and other individuals. Robinson et al. (2016) and Opara et al. (2017) mention the concept of handwashing immediately after handling any patient. This strategy can be adopted as a way of ensuring that medical practitioners do not subject their clients or themselves to HCAIs.

In addition, Al-Niaimi, Chiang, Chiang, and Williams (2013) introduce the idea of using gloves by nurses and other medical practitioners when carrying out all health procedures. However, despite the widespread adoption of this method in virtually all healthcare facilities around the globe, the study by Al-Niaimi et al. (2013) depicts a worrying finding whereby only 1% of their sampled physicians deployed gloves appropriately in line with the sensitivity of procedures they were conducting. Hence, this method may not be efficient in preventing the spread of HCAIs. Hence, although hand hygiene is the most effective approach to dealing with hospital-acquired infections in relation to all methods mentioned above (Robinson et al., 2016), many medical practitioners do not embrace it. Hence, it is crucial to examine strategies that have been proposed to boost compliance with hand hygiene to reduce the transmission of HCAIs.

Strategies for Boosting Hand Hygiene Compliance

The available literature presents various strategies that have been deployed to enhance hand hygiene compliance as a measure for reducing the spread of HCAIs. The goal is to encourage medical practitioners, nurses, patients, and even other parties to disinfect their hands before and after interacting with people within healthcare centres. For instance, the study by Parks, Schroeder, and Galgon (2015) investigated the impact of having personal gel dispensers in hospitals. Before the implementation of this method, the sample utilised by Parks et al. (2015) indicated a 34% compliance level, which rose to 63% after such devices were introduced. This improvement is substantial because it enhances patients’ safety by ensuring that almost all health practitioners carry out their duties in a hygienic manner.

However, Phan et al. (2018) believe that the lack of awareness regarding the need for operating in hygienic healthcare environments has contributed to the observed non-compliance among all involved parties and, consequently, the underlying high levels of HCAIs. These authors conducted a study to examine the impact that a handwashing education programme had on compliance rates in some Vietnam-based health facilities. Findings from the article by Phan et al. (2018) revealed improved hand hygiene conformity levels and hence the reason why suggestions were made to have this approach adopted in emerging economies to reduce cases of hospital-acquired infections. This research assumed that developing countries are at a high risk of contracting infections with healthcare facilities because they are not well equipped with knowledge regarding the impact of using dirty hands on their health.

In another study by Bolton, Rivas, Prachar, and Jones (2015), the method of hiring individuals who can encourage all people within hospital settings to wash or disinfect their hands was found to enhance their compliance levels. This research appreciates the existence of ignorant individuals who may not cleanse their hands unless pushed to do so by others. Despite coming at a cost, this method may be regarded as the most effective compared to previous approaches to ensuring hand hygiene conformity. Such hired people ensure that all individuals are entering and leaving a particular hospital environment to disinfect their hands, as opposed to earlier methods that only allow persons to do so voluntarily. Consequently, it can significantly reduce the spread of healthcare-acquired infections, including saving society from communicable disease outbreaks.

Conclusion

People operating within healthcare environments are at a high risk of contracting HCAIs, especially if they do not embrace proper hygiene. This study has revealed that various infections spread through contact between susceptible and healthy people. In addition, hands have been depicted to play a huge role in spreading many communicable diseases. Methods such as the failure to cover coughs and sneezes and improper handling of blood and urine samples, among others, have been found to facilitate the spread of HCAIs. However, hand hygiene has been presented as the most effective way of reducing or preventing the transmission of infectious diseases. To boost compliance with this approach, this paper has suggested various methods, including the implementation of personal gel dispensers, creating awareness through education programmes, and hiring individuals who can encourage all people entering and leaving hospital settings to disinfect their hands.

References

Al-Niaimi, F., Chiang, Y., Chiang, Y., & Williams, J. (2013). Latex allergy: Assessment of knowledge, appropriate use of gloves and prevention practice among hospital healthcare workers. Clinical & Experimental Dermatology, 38(1), 77-80.

Baltes, A., Akpinar, F., Inankur, B., & Yin, J. (2017). Inhibition of infection spread by co-transmitted defective interfering particles. PLoS ONE, 12(9), 1-17.

Bolton, P., Rivas, K., Prachar, V., & Jones, M. (2015). The observer effect: Can being watched enhance compliance with hand hygiene behaviour? A randomised trial. Asia Pacific Journal of Health Management, 10(3), 14-16.

Centres for Disease Control and Prevention. (2017). How infections are spread. Web.

Chen, C., Lin, C., Jiang, Z., & Chen, Q. (2014). Simplified models for exhaled airflow from a cough with the mouth covered. Indoor Air, 24(6), 580-591.

Magill, S., Dumyati, G., Ray, S., & Fridkin, S. (2015). Evaluating epidemiology and improving surveillance of infections associated with healthcare, United States. Emerging Infectious Diseases, 21(9), 1537-1542.

Opara, P., Alex-Hart, B., & Okari, T. (2017). Hand-washing practices amongst mothers of under-5 children in Port Harcourt, Nigeria. Paediatrics & International Child Health, 37(1), 52-55.

Parks, C., Schroeder, K., & Galgon, R. (2015). Personal hand gel for improved hand hygiene compliance on the regional anaesthesia team. Journal of Anaesthesia, 29(6), 899-903.

Phan, H., Tran, H., Tran, H., Dinh, Anh P., Ngo, T., … Gordon, C. (2018). An educational intervention to improve hand hygiene compliance in Vietnam. BMC Infectious Diseases, 18(1), 1.

Robinson, A., Lee, H., Kwon, J., Todd, E., Perez Rodriguez, F., & Ryu, D. (2016). Adequate hand washing and glove use are necessary to reduce cross-contamination from hands with High bacterial loads. Journal of Food Protection, 79(2), 304-308.

Sifferlin, A. (2014). 4 diseases making a comeback thanks to anti-vaxxers.Time. Web.

Simons, H., Unger, Z., Lopez, P., & Kohn, J. (2015). Predictors of human papillomavirus vaccine completion among female and male vaccine initiators in family planning centres. American Journal of Public Health, 105(12), 2541-2548.

World Health Organisation. (2018). Infection prevention and control. Web.

Yallew, W., Kumie, A., & Yehuala, F. (2017). Risk factors for hospital-acquired infections in teaching hospitals of Amhara regional state, Ethiopia: A matched-case control study. PLoS ONE, 12(7), 1-11.

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