Importance of Handwashing in Preventing Hospital Acquired Infections
PICOT Question: Does Hand Washing Reduce Hospital Acquired Infections
Hospital-acquired infections (HAIs) are contracted in by patients in a healthcare setting while they are undergoing treatment or surgery. They include bloodstream infections, surgical site infections, and urinary tract infections caused by viral, bacterial, and fungal pathogens from hospital surfaces and tools or transferred from one patient to another or from a health care worker to a patient (Stubblefield, 2016). In patients, infection is referred to as an HAI if it occurs during or within a short period of their stay in the hospital and is not related to the illness that took them to the hospital initially. Health care workers also contract HAIs through similar methods as they take care of patients in hospitals. The majority of HAI cases in both patients and medical professionals are reported in the intensive care unit (ICU), contributing substantially to morbidity and mortality rates.
Many methods, including handwashing, can prevent HAI. Health care workers are advised to wash their hands before and after conducting patients’ rounds and procedures to prevent infecting patients and themselves. Similarly, patients should wash their hands frequently to prevent contracting infection from hospital surfaces, workers, and other patients. Handwashing with soap and water alone is proven to reduce bacterial count on hands by 24 to 77 percent while using alcohol-based decreased the count by 83% (Stubblefield, 2016). This is because handwashing removes surface dirt, oil, and loose skin from hands that carry most of the germs. Towel drying the hands enhances the process as opposed to using a warm-air dryer, which may introduce new bacteria.
Other methods of preventing HAIs include the use of personal protective equipment (PPE) in the hospital, such as masks, gloves, and gowns (Segal, 2016). Gloves are put on before sterile procedures when there are chances of coming into contact with bodily fluids and when caring for patients where contact precautions have been issued. Secondly, gowns, including isolation and procedure gowns, protect clothing from infection by blood and body fluids. Third, masks and respirators, for example, N95 respirators, ensure protection from infectious droplets and particles whose portal of entry is the nose or mouth. However, PPEs do not offer complete protection as hand hygiene is important before and after glove use. This is because hands are prone to infection when handling PPE, for example, when removing the masks after a shift.
Generally, hand hygiene is the most important intervention towards preventing HAIs and is more successful when used alongside other interventions such as PPEs. In a study conducted among Navy recruits, for example, regular hand washing in clinics reduced the number of respiratory infections by 45%, with the group participating in handwashing recording the least number of infection cases (Harvard Medical School, 2016).
HAIs are detectable in patients within different time ranges; up to 48 hours after admission, up to 3 days after being discharged from hospital, and up to 30 days after an operation. Changes to the infection rates should be noticeable within a short time after applying handwashing intervention in a health care facility. The changes are identified from hospital statistics as the number of HAIs will show a gradual decrease. Hospitals could begin with awareness campaigns to educate workers on the importance of handwashing and to place reminders in strategic hospital locations. This should take up to a week, after which an analysis of the efficiency of the activity can begin.
References
Harvard Medical School. (2016). Wash your Hands. Health Harvard.
Segal, P. (2016). The Role of Personal Protective Equipment in Infection Prevention History. Infection Control Today.
Stubblefield, H. (2016). What Are Nosocomial Infections? Healthline.