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Evidence based practice in nursing
Evidence based practice in nursing
Evidence based practice in nursing
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Hand sanitation has long been known to reduce the spread of disease and today alcohol based hand sanitizers are used in addition to washing hands with soap and water. Currently there are evidence based practices (EBP) guidelines for hand sanitization versus hand washing for bedside nurses. There’s currently significant evidence for using one method over the other but some barriers prevent the proper level of sanitation.
Significance to Practice
Healthcare acquired infections (HCI) are very common in today’s hospitals and new forms of drug resistant organisms have emerged limitation of the spread of these organisms are of great significance. Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Clostridium difficile(CDIF), surgical site infections, urinary tract infections, and ventilator related pneumonias are common HCI’s. Surgical site infections alone according to an annual report from the Colorado Department of public health estimates national financial toll of 3-10 billion dollars.
Barriers
Some common barriers to healthcare workers can be cost, access to hand sanitation stations or materials and lack of knowledge of current best care practices. Lack of proper hand hygiene increases the likely hood of a healthcare acquired infection. Cost to the hospital and the patient increases with longer hospital stays and more treatment required. Current practices should not be changed but education in the reasoning of these practices needs to be increased in the healthcare community.
Research Literature
Several articles specifically address not just hand hygiene but specifically hand washing or the use of alcohol based hand sanitizers.
Article 1: “Putting Evidence Into Nursing Practice: ...
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... and more effective if hands are not visibly soiled but studies are still examining the use on soiled hands.
Works Cited
Pickering, A. J., Davis, J., & Boehm, A. B. (2011). Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. Journal of water and health, 9(3), 429-433.
Flynn, Martin, S. A., Burns, S., Philbrick, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. Critical Care Nurse, 33(2), 28-44. doi:10.4037/ccn2013787
Patrick, M., and Van Wicklin, S. A. (2012). Implementing AORN Recommended Practices for Hand Hygiene. AORN journal, 95(4), 492-507.
World Health Organization. (2009). WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK144041/
Parents and teachers encourage children to wash their hands with soap and water after using the bathroom, touching dirty objects, and sometimes before eating. Next to every tissue box there will most likely be a bottle of hand sanitizer that kills 99.9% of germs. Both hand soap and hand sanitizer kill off the germs and bacteria that can cause infections and diseases. Which one works best? The purpose of this experiment is to show which is more effective, hand soap or hand sanitizer (Bjornsson). To prove this, Bjornsson writes up a lab using the growth of bread mold to help identify the results of both products (Bjornsson). I believe that hand soap works better than hand sanitizers because doctors remind us that we should wash our hands especially during flu season to keep us healthy. Therefore, the hypothesis for this lab is that the hand soap will be the better alternative and will slow down the growth of bread mold more than the hand sanitizer in this experiment.
Health tips. Hand hygiene. (2009). Mayo Clinic Health Letter (English Ed.), 27(12), 3. Retrieved from
According to CDC policy if the patient before Jean Deere did not have a diagnosis with the possibility of disease transmission, the proper method of hand sanitization would be alcohol based hand rub.
There are several benefits to double-gloving that have been supported by recent studies [1-4]. By double-gloving, it has been shown that the transfer of virus to healthcare workers’ hands is significantly decreased, as compared to single gloving [1]. Perhaps the incidence of nosocomial infections could be reduced if double-gloving were a requirement in healthcare settings. In the operating room (OR), double-gloving has been shown to provide superior protection against potential exposure to blood-borne pathogens [2]. Breaking the barrier between an OR nurses’ hands and the external environment was shown to occur in 8.9% of cases in one study in which single-gloving was practiced during surgical procedures [2]. Remarkably, in the same study, it was shown that when double-gloving was practiced, there was not a single case of both layers of gloves being perforated [2]. From the evidence provided in that study, one could assume that when double-gloving is practiced, it is virtually impossible for the hands of a healthcare worker to become exposed to the external environment during a sur...
As long as the hand sanitizer contains at least 60 percent alcohol and is used correctly, then it does not matter which form of hand sanitizer is used. Hand sanitizers kill most, but not all of the bacteria and viruses on contact, but it does not work well when there is grime from cooking or gardening because the grime makes a barrier.
“The CDC is the primary developer of national infection control and prevention guidelines, often in collaboration with its Healthcare Infection Control Practices Advisory Committee, which is responsible for research and dissemination of the latest information for preventing disease transmission” (Griffis, 2013, p. 175). Infection control will continue to be a topic of discussion as long as germ transmission is still happening. Among these studies is the concern the frequent nonadherence to contact precautions is a huge issue that many studies are still very concerned about (Jessee & Mion, 2013, p. 966). The writer is also concerned with the blatant disregard for hand hygiene that appears to be happening in the medical field. What about what is best for the patient. Do the people that do not use proper hand hygiene not understand how important it
One factor prevalent in our nation’s hospitals which, although under-represented by the media, is significantly detrimental to the advancement of the United States healthcare system is Hospital/Healthcare Associated Infections, or HAIs. These infections were first identified as a serious threat to patient safety during the 1930s. In the 1940s, The British Medical Council appointed infection officers in various hospitals to attempt to regulate and control causes of infection, although such officers only became common in the 1950s during a severe outbreak of Staphyloccosus. After a brief investigation had been conducted, it was found that nearly 100% of patients and staff in various British hospitals had contracted elements of the virus through lack of hygienic precaution during open wound surgeries. Fortunately, the ready availability of penicillin prevented a severe outbreak, but the continued overuse of the drug resulted in drug resistant bacteria and virus and the discovery of the Staphyloccosus Aureus - a virulent skin pathogen immune to initial penicillin serums and recognized as the first antibiotic resistant bacterium - in the late 1960s. By the early 1970s, the drive to control hospital infections was well established in the United States, however, the movement was unorganized and there was no success in eliminating infections associated with medical practices at the time. It was not until 1976 that the control of infectious diseases in hospitals was transformed from a movement to a mandate when The Joint Commission on Accreditation of Hospitals demanded that accredited hospitals have infection control programs. Currently the majority of research of HAIs is conducted by the CDC through The Prevention Epicenter Program, w...
The focus of health care is and has always been, practicing good hygiene, living a healthy lifestyle, and having a positive attitude reduces the chance of getting ill. Although there is not much prevention we can take for some of the diseases but we can certainly practice good hand hygiene to prevent infection and its ill effects. Research proves that hand washing is surely the most easy and effective way to prevent infection in health care. The question for this research: Is Hand washing an effective way to prevent infection in health care? It led to the conclusion that due to the high acuity, high patient: staff ratio, and lack of re evaluation certain units in the health care facilities cannot adhere to correct hand washing guidelines. Hand
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
“Failure to attend to hand hygiene has serious consequences: it has a negative effect on patient safety and the quality of patients’ lives, as well as on their confidence in healthcare delivery. However, the prevalence of hand hygiene omission is still high” (Canadian Disease Control, 2016 p 1). Washing hands before and after patient contact seems like a simple solution to prevent the spread of bacteria between patients. But it is not as simple as it seems.According to new CDC data, “approximately one in 25 patients acquires a health care-associated infection during their hospital care, adding up to about 722,000 infections a year. Of these, 75,000 patients die from their infections ( CDC, 2016 p 1).” Leaving a finacial burden on Canada’s health care
Stout, A., Ritchie, K. & Macpherson, K. (2007). Clinical effectiveness of alcohol-based products in increasing hand hygiene compliance and reducing infection rates: a systematic review. Journal Of Hospital Infection, 66 (4), pp. 308--312.
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
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase in the number of days the patients stay in the hospital. Hospital acquired infections make the patients worse or even cause death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
“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
Avoiding infection or, at least, breaking the chain of transmission is vital in any setting, but more so in healthcare environments where infections and vulnerable hosts are moving under the same roof. What needs to be done, then?