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Literature review compliance hand hygiene
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What we know today about maintaining a clean nursing environment can be traced back to its roots, over 150 years ago with Florence Nightingale. A lot of what Nightingale wrote about and practiced stemmed from providing a clean nursing environment. Air quality, water quality, noise, light, and nutrition were also her priorities, but cleanliness was the common factor. Over the years, cleanliness has now become infection control within the hospital setting and standards and guidelines have been made to ensure patient safety.
The following literature review will examine the standard of practice for maintaining a clean nursing environment, what can be concluded from the evidence, and what gaps need to be closed to further improve standards of care.
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APIC has also made guidelines that are evidence-based strategies for nurses on preventing and eliminating HAIs. Such guidelines have impacted nursing for the better, as evidence-based strategies have proven to decrease the number of HAIs nationwide.
Literature Review of the Evidence
The standard of practice for maintaining a clean nursing environment entails many aspects, but for the purposes of this literature review evidence pertaining to hand hygiene, prevention of health-acquired infections, and disinfecting healthcare environments will be discussed.
First and foremost, hand hygiene is a simple and effective solution to reduce both the spread of infection and multiresistant germs, and to protect patients from healthcare-acquired infection. The World Health Organization (WHO) developed guidelines on hand hygiene in healthcare with a global prospective to support hand hygiene promotion and improvement in healthcare facilities worldwide. Hand hygiene can be defined as handwashing, antiseptic handwash, antiseptic hand rub, or surgical hand antisepsis. According to the Center for Disease Control (CDC), the rationale for hand hygiene are the potential risks of transmission of microorganisms to patients, healthcare worker colonization or infection caused by organisms acquired from the patient, morbidity, mortality, and costs associated with healthcare-acquired
Toronto Public Health encourages everyone to cover their coughs and sneezes and make disposable tissues available for this purpose (City of Toronto). As well, they stress how important hand hygiene is after having coughed or sneezed. One of the most important concepts of Nightingales theories is that of cleanliness. She believed that “Every nurse ought to be careful to wash her hands very frequently during the day. If her face too, so much the better” (Nightingale, 2005). As well, nightingale emphasized the linkage between ventilation and cleanliness when she stated, “without cleanliness, you cannot have all the effect of ventilation; without ventilation, you can have no thorough cleanliness” (Nightingale, 2005). Toronto Public Health incorporates those theories in correlation with each other as well. They state that “environmental control measures are insufficient when used alone; they need to act in concert with administrative practices (having a person were a mask, hand washing etc.), to reduce the risk of TB transmission (Environmental Control Best Practices,
This literature review will analyze and critically explore four studies that have been conducted on hand hygiene compliance rates by Healthcare workers (HCWs). Firstly, it will look at compliance rates for HCWs in the intensive care units (ICU) and then explore the different factors that contribute to low hand hygiene compliance. Hospital Acquired infections (HAI) or Nosocomial Infections appear worldwide, affecting both developed and poor countries. HAIs represent a major source of morbidity and mortality, especially for patients in the ICU (Hugonnet, Perneger, & Pittet, 2002). Hand hygiene can be defined as any method that destroys or removes microorganisms on hands (Centers for Disease Control and Prevention, 2009). According to the World Health Organization (2002), a HAI can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. The hands of HCWs transmit majority of the endemic infections. As
Each year the number of health care associated infections (HAI) increases and has been estimated to be in the hundreds of millions of people around the world. In the United States this accounts for approximately 1 in 25 patients ("Hand Hygiene Basics," 2014). Health care associated infections are considered to be the most persistant adverse event in health care. Hand washing is considered to be one of the best methods for preventing the spread of infection and that poor hand hygiene places patients at high risk ("The Evidence for Clean," n.d.). Patients receiving care in hospitals, long term care facilities, and nursing homes are especially at high risk for developing infections while being cared for. Most health care associated infections
The systematic review; Interventions to improve hand hygiene compliance in patient care, conducted by the Cochrane Collaboration investigated inventions to improve hand hygiene compliance within patient care. The review included 2 original studies with an additional two new studies (Gould & Moralejo et al., 2010). Throughout the review it was affirmed that among hand hygiene is an indispensable method in the prevention of hospital-acquired infections (HAI), the compliance among nurses’ is inadequate. Nurses are identified within the public as dependable and trustworthy in a time of vulnerability due to their specialised education and skills (Hughes, 2008). Thus, it is imperative that evidence based practice is cond...
As health advocates, nurses have a responsibility to communicate the importance of hand hygiene to their patients, through informing and enabling the practice of hand sanitising, along with ensuring patients are able to continue to have their personal hygiene needs met while in
In nursing, the patient is often viewed as the main priority of the nursing staff. The nurse works to provide care for the patient based on the patient 's admitting diagnosis. However, the patient must be looked at as a part of the greater system they exist in such as their family or home environment. While the patient may be ill due to a bacterial infection or virus, their family environment also plays a role in their overall health and wellness.
In today’s nurse, the work environment has computers and other equipment that were not available a hundred years ago. A technologically advanced hospital can provide an efficient and accurate care to the patient. For instance, computerized medical reports are beneficial when a doctor or a nurse want to trace the medical history of an altered or intubated patient who may not be able to give accurate information during critical situations. These advances act as a safety feature for the patient and hospital. Also, the nursing profession today is no longer for females; it is more culturally diverse and now includes the male gender. Today, there are many organizations that mandate rules and regulations for the nursing practice like the ANA’s (American
Healthcare-associated infections can occur in any type of healthcare facility. It usually begins from cross contamination from healthcare providers to the patient, however, it can come from other patients, hazardous medical procedures, and contaminated surgical tools too. Healthcare workers play the leading role in preventing healthcare-associated infections. Srigley et al. (2013) stated that “Healthcare worker (HCW) hand hygiene is considered to be one of the most important interventions for the prevention of HAIs and AROs. However HCW hand hygiene is typically poor, with a median compliance of 40%, and few interventions have been demonstrated to result in significant and sustained improvement” In order to
Medical asepsis plays an integral role in infection control within a health care facility. It includes procedures used to decrease and prevent direct contact with blood or bodily fluids and emphasizes keeping the environment clean on a regular basis (Curchoe, Astle, & Hobbs, 2014). In order to achieve optimal health, individuals depend on practices and techniques that control and ultimately prevent the transmission of infection. These practices and techniques can help avoid the transmission of infections by creating an environment that protects both health care workers and patients from communicable diseases. Good hand hygiene has been stressed as the single most important measure to prevent cross-infection to patients in health care facilities
To give quality nursing care to patients, I will give good personal hygiene care by assisting patients who need it and promoting the independence of patients that can see to their personal care. I will also assist with eating and drinking when required so patients can get the right nutritional requirements needed. I will meet the toileting needs of patient and show patients respect and dignity at all times.
The world loves to see great organizations that are known for their achievement and meeting their goals and putting smiles on other people/patients faces. Healthy work environments make sure that they show each other great communication with whatever they do inside the workplace. It is a good thing for all workers inside of any workplace of health to practice speaking to each other during procedures and especially during any breaks. This together forms special bonds and chemistry. When there is great chemistry between workers, they feel way more comfortable with the decisions and are less likely to make bad decisions or make mistakes because of not feeling like they are doing the right thing. All of this is just a more broad way of saying collaborative relationships, and promote decision making among all nurses is so important. Uncomfortable workers will always feel that they cannot do anything on their own. So most of the time when they do not feel like they can do something on their own they would normally try and leave to get assistance from another worker or just act very hesitant. No patient wants assistance from a worker that doesn’t feel comfortable. So that is why workers should communicate with each other, and not want to feel bothered. Workers would then learn to freely go around and keep the place clean. Sweeping, sanitizing, and being very precautious is what people love to see when stepping in because unhealthy work environments can have adverse consequences on the quality of care delivered as well as nurses intention to leave the profession. Workers wouldn’t want to work in a profession that has an unhealthy work environment because they are just as careful with other people’s lives just as they are with theirs. Unhealthy work environments aren’t the right places to perform work in either. They are not the right places to perform procedures or not
A theory I can relate to is Nightingales theory, I found her theory to be extremely interesting. A patient health is affected by the environment that they are in, whether it is at the hospital or at their house. Once a patient is discharged the nurse should be aware of the patient home environment, what they have access to, and what they don’t have.
“Researchers in London estimate that if everyone routinely washed their hands, a million deaths a year could be prevented” (“Hygiene Fast Facts”, 2013, p. 1). Hands are the number one mode of transmission of pathogens. Hands are also vital in patient interaction, and therefore should be kept clean to protect the safety of patients and the person caring for the patient. Hand hygiene is imperative to professional nursing practice because it prevents the spread of pathogens, decreases chances of hospital-acquired infections, and promotes patient safety. There is a substantial amount of evidence that shows why hand hygiene is important in healthcare
Patient’s personal hygiene is a vital part of the nurse’s role. Young (1991) described cleanliness as a basic human right, not a luxury the need for the patient to physically cleansing and which would include skin, hair and nails.
Florence Nightingale’s first of Thirteen Canons is Ventilation and Warming. According to Nightingale (1859/1992) “the first rule of nursing is to keep the air within as pure as the air without” (p.8). Being a nurse means thinking about little things to help the patient such as opening a window and letting fresh air in. By opening the window for a few minutes it allows the patient to know the nurse has considered his or her well-being. The second of the Thirteen Canons is Health of Houses. There are five essential points to the health of houses: pure air, pure water,