One of the primary sources that can lead to pathogenic infection is the contaminated hand of the nurses that directly increase the risk for the complication of the patient. The increased rate of hospital-acquired infection increases the need for proper hand hygiene technique to decrease the rate of healthcare-associated infections (Toney-Butler & Carver, 2020). According to the Centers for Disease Control and Prevention (2017) discusses that hospital-associated infection increases the complication of the individual which lead to increase mortality rate. The data indicate that 1 in 25 patient acquires the hospital care-associated infection that directly increases the hospital stay and leads to an increase in financial burden. The study presented by Haque et al. (2018) describe that human skin is considered to be a favourable place for microorganism growth and thus they act as a reservoir to transmit the disease and increase risk of the patient to acquire the healthcare-associated infection. The need is to understand the impacts of hand hygiene over the health are associated infection as it is one of the major health care burdens.
Hospital-acquired infection is considered to be one of the adverse events that occur during hospitalization that directly affect multiple aspect increase hospital stays, increased treatment cost and increase mortality. The rate of the hospital-acquired infection is considered to be 15.5 per 100 patients in developing countries that lead to increase burden over the health care sector (Nekkab et al., 2017). The patients in intensive care are at higher risk to acquire the hospital-acquired infection due to low immunity and continuous contact with the health care professional. The prevalence of hospital-acquired infection in the developed country is 7% and in developing countries is 10% (Khan et al. 2017).
The literature review section of the study helps to utilize the evidence-based to understand the research associated with the topic that helps to identify the gap in the research. The review assists the scientist to identify the clear goals, help in evidence collection and engage in the reflective critique that helps to understand the topic by considering every aspect (Maggio et al., 2016).
The major concerns for the health care sector of the low and middle-income countries are a healthcare-associated infection that is a threat to patient safety, increased financial burden and increase health care burden. The prevalence of healthcare-associated infection is higher in low or middle-income countries than in high-income countries. The evidence indicates that hand hygiene directly decreases the healthcare-associated infection rate. The hand hygiene is one of the important factors that are associated with the decreasing rate of healthcare-associated infection. The health care professionals are expected to perform the hand hygiene technique in two-zone which include patient and health care zone (Loftus, et al., 2019). According to the World Health Organization (2009), human hand skin contains multiple microorganisms that increase the chances of transmission of the infection. The transient microflora of the microorganism that resides over the superior layers of the skin that is associated with health care practises that lead to transmission of the infection. The health care associate infection increases the mortality rate of the individual that is directly associated with the transmission of the infection for the health care professional to patients.
One of the article presented by Shobowale, Adegunle & Onyedibe (2016) described hand hygiene is one of the important factors in the infection control program that are associated with the hospital. Hand hygiene is a powerful method that helps to decrease the cross-transmission of the pathogen that can lead to infection. The hands usually have two types of microflora resident and transient that directly leads to an increased rate of health care associate infection. The 15-30% rate of the healthcare-associated infection decrease if the health care professional performs an accurate hand hygiene procedure. Moreover, the article presented by Sickbert-Bennett et al., (2016) discusses the direct association of the hand hygiene with the hospital-acquired infection. The major issue with hand hygiene is to maintain the disciplines of personally to perform hand hygiene that decreases the infection rate.
The organization is required to form the proper hand hygiene guideline that can abet the health care professional to know the accurate method for hand hygiene and its importance in reducing the infection rate. One of the studies conducted by Sharma (2018) discussed how cross-transmission that occur due to the contaminated hand of the health care professional and they become the route of transmission from one patient to another. The reason for the contamination of the health care professional hand can be understood by the presence of organism on patient skin, organism shed nearby, contaminated equipment and surrounding of the individual. The health care professional performing hand hygiene routine up to 90% can help to decrease the chances of healthcare-associated infection up to 24%.
One of the studies conducted by Ataiyero et al. (2018) discuses about the different barriers that are associated with the hand hygiene practise that directly elevate the rate of healthcare-associated infection in the patient. The different barriers that are associated with hand hygiene include infrastructure deficit that includes incompetency of the hospital management system to provide necessary hand hygiene resources like soaps, water, hand sanitizer and wash sink. The barriers for the hand hygiene procedure are increased workload of the nurses that directly creates pressure over the individual to attend the entire patient and time constraints decrease the hand hygiene practises. The third barrier includes occupational category is also considered to decrease the hand hygiene practice as it is considered that higher the professional level the better hand hygiene practises. The decreased knowledge and proper training are also considered to be one of the barriers associated with a decreased rate of hand hygiene in health care professional. Another article proposed by Aziz et al. (2018) discussed that the barrier that is associated with a decreased rate of hand hygiene include decrease understanding of the health workers and no proper training for right-hand hygiene procedure. The age is also considered to be one of the barriers that are associated with hand hygiene as younger individuals are more aware of different hand hygiene technique but older individual lack hand hygiene technique.
Centre for Disease Control and Prevention (2020) describe how hands hygiene is one of the important aspects to decrease the chances of infection. The practise of hand hygiene can help to decrease the potentially deadly germs and decrease the chances of transmission. The two methods that can be utilized to perform hand hygiene to decrease hospital-acquired infection include alcohol-based sanitizers and washing with soap. The hand hygiene directly helps to decrease the infection the hand hygiene should be performed before and after the patient assessment. According to Australian Commission on Safety and Quality in Health Care (2019), action 3.8 of standard Preventing and Controlling health care Associated Infection discuss the role of the hand hygiene process in reducing the healthcare-associated infection and hand hygiene program can help to improve the hand hygiene practise in health care professionals. The Hand Hygiene Initiative the programs that aim to increase the hand hygiene routine in health care associate. The hand hygiene program includes different aspect like alcohol-based hand sanitizer at point of care, increase understanding of the workforce, performance feedback from seniors, review plan to identify gap, proper hand hygiene training and identification of the less skilled health care professional.
The study conducted by Martos-Cabrera et al. (2019) discusses the WHO initiative that aims to improve the hand hygiene technique that is “Clean Care Is Safer Care” campaign. This campaign aims to increase the understanding of the health care professional related to the right-hand hygiene technique that should be used before and after attending the. The method includes five steps that start with washing hand following by applying soap or hydroalcoholic solution. The second step of the technique includes rubbing the hand from palm to palm followed by the back of both the hand with interlaced fingers. The third step of the technique includes repeating the process with another hand by rubbing right-hand thumb and finger in circulation motion over left palm. The fourth step of the technique rubbing for at least 20 second and the last step includes rising with water.
On the other hand, the article proposed by Seo et al., (2019) discusses the WHO guideline regarding the five-moment guideline for the health care professional for the hand hygiene protocol. The five-moment guideline includes five-time healthcare professional should perform hand hygiene to reduce the chances of healthcare-associated infection. The first step is before touching patient health care professionals are expected to perform hand hygiene to reduce chances of microorganism transmission. The second aspect includes before a cleaning process as wound and open injury can easily catch infection thus there is a need to perform hand hygiene before the cleaning process. The third aspect includes before exposure to the body fluid as body fluid acquired infection associated with health care facility has a higher rate. The fourth aspect is after touching the patient that directly help to reduce the chances of contamination from one patient to another patient thus require hand hygiene. The last aspect is performing hand hygiene in patient surrounding as air microbes are also one of the major factors that can lead health care associate infection (World Health Organization, 2006).
The study revealed the burden posed by the healthcare-associated infection over the health care setting and how hand hygiene is one of the promising methods to decrease the rate of healthcare-associated infection. Hand hygiene is one of the effective methods because health care associate hand is considered to be a reservoir of the microbial growth that can lead to transmission of the infection. The health care professional following proper hand hygiene during working can help to decrease the chances of healthcare-associated infection because they remain in continuous contact with the patient. The hand hygiene focuses to reduce the contamination from the hand can occur due to different reason like from the patient, surrounding environment or equipment. Many barriers are associated with the hand hygiene practice like lack of resources, decrease knowledge of the individual, lack of training and heavy workload. Many government organization framed hand hygiene campaign to improve the hand hygiene that includes Hand Hygiene Initiative, Clean Care Is Safer Care campaign and five-moment guideline. The aim of these campaigns aims to increase awareness of the health care professional regarding accurate hand hygiene procedure that should be formed to decrease the rate of healthcare-associated infection.
Ataiyero, Y., Dyson, J., & Graham, M. (2018). Barriers to hand hygiene practices among health care workers in sub-Saharan African countries: A narrative review. American Journal of Infection Control. 2018, 1-9. DOI:10.1016/j.ajic.2018.09.014
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Aziz, Md & A.R., Amit, & Sajon, Sadiur. (2018). Knowledge and attitude of hand hygiene maintenance among the health care workers and patients in hospitals of Jessore district, Bangladesh. Pharmacologyonline. 2. 1-8.
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Seo, H.-J., Sohng, K.-Y., Chang, S. O., Chaung, S. K., Won, J., & Choi, M.-J. (2019). Interventions to improve hand hygiene compliance in emergency departments: A systematic review. Journal of Hospital Infection, 102, 394-406. DOI:10.1016/j.jhin.2019.03.013
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