Evidence-Based Practice

 

 

 

 

 

 

 

Evidence-Based Practice

 

Name

Institutional Affiliation (s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Picot Question:

P- Methicillin-Resistant Staphylococcus aureus (MRSA)

I-Use of hand sanitizers

C- Hand Washing

O- Reduce Incidence

T- Two Months

Clinical question- Are hand sanitizers as effective as hand washing in reducing the incidence of MRSA.

Introduction

Frequent hand washing is among the main factors that reduce the spread of infections in hospital settings. This follows the increased number of hospital-acquired infections (HAIs), the increased severity of diseases, and the development of drug-resistant microorganisms (Mathur, 2011). As such, healthcare providers need to observe the basics of infection control, which is hand washing. This happens since multiple scientific studies indicate that if hand washing is adequately implemented, it can reduce the risk of transmission of HAIs. This paper sought to evaluate hand sanitizers’ effectiveness compared to hand washing in reducing the spread of Methicillin-Resistant Staphylococcus aureus (MRSA).

The researcher used online libraries to search for information concerning the topic. Some of the databases searched include Cochrane, NCBI, and Worldcat. The keywords used during the literature search include hand sanitizer, hand washing, effectiveness, and reduce incidence.

The research questions are

• Are hand sanitizers effective in reducing the incidence of MRA in hospital settings?
• What is the MRSA bacteria/
• What are the benefits of observing hand hygiene in hospitals?

Summary of major findings of each study

About 1.4 million acquire HAIs at any one time in the world. Nasocomial infections are usually caused by poor hand hygiene among healthcare professionals. Hands are considered the main routes through which microbes and infections are transmitted from one person to another (Amadi, Patience & Olayiwola, 2018). Hand sanitization is considered as an alternative method to hand washing that can be used after hand washing or when water is not available. The antimicrobial sanitizers have active ingredients made of ethanol or isopropanol. Also, hand sanitizers are made of inactive ingredients such as glycerine, polyacrylic acid, propylene, alcohol, ethanol, glycol, and plant extracts. WHO recommends the use of hand sanitizers in cleaning hands in healthcare settings. In the US, HAIs cause an estimated half a million hospitalizations and 50, 000 fatalities annually (Kakroo et al., 2020). The MRSA is a normal human flora present in the skin and mucous membranes of healthy people. The MRSA bacteria have various virulence factors such as toxins and immune avoidance properties that affect the host tissues during infection.

Hand washing is believed to reduce the incidence of HAIs dramatically. Between 1975 and 1985, the CDC developed guidelines on the need to adopt handwashing procedures in hospitals (Mathur, 2011). Majorly, the CDC advocated for handwashing using non- antimicrobial soaps when handling patients and instruments in healthcare settings. The use of hand sanitizers was only recommended in cases when there were no sinks. In 1995, the Hospital Infection Control Practices Advisory Committee (HICPAC) advocated using antimicrobial soaps of waterless antiseptic agents on the hands when caring for highly infected patients (Chaudhari, 2020). This directive was followed by the 2002 CDC recommendation for the use of alcohol-based hand rubs to decontaminate hands when handling different patients. Further, the CDC advised that healthcare professionals must wash hands with liquid soap in cleaning visibly contaminated and soiled hands. It is necessary to wash hands between patients since hand contamination with pathogens occurs due to direct patient contact (Bondurant et al., 2019).

The hands are usually colonized by two types of microbes; the resistant flora and the transient flora that occurs on the skin. Amadi, Patience & Olayiwola (2018) stated that healthcare providers are likely to acquire transient microorganisms when they handle patients or touch surfaces infested with microorganisms. Methicillin-Resistant S. aureus (MRSA) is a pathogen that colonizes the hands of healthcare providers who come into contact with patients. Usually, patients shed skin epithelial cells daily that contain microorganisms. These pathogens are likely to contaminate the bed linens, gowns, and furniture. The infection of hands with MRSA is associated with the increased prevalence of nosocomial infections (Mathur, 2011)

Washing the hands properly is among the surest and most affordable ways of preventing the transmission of HAIs and other resistant microorganisms. Handwashing reduces the transmission of MRSA from one patient to the other (Mathur, 2011). Increased washing of the hands reduces the incidence of MRSA. Also, hand sanitizers such as benzalkonium chloride (BZK) are associated with the significant killing of the S. aureus on the skin (Bondurant et al., 2019).

The antimicrobial activity of hand sanitizers defines its ability to kill or inhibit the growth of bacteria. Antimicrobial activity is necessary as it prevents diseases and infections in the human body. Hand sanitizers contain an antiseptic property by incorporating a specific amount of germicidal substances that increase its antimicrobial activity (Chaudhari, 2020). As such, hand sanitizers can kill germs and bacteria. Antiseptic substances usually kill bacteria at different concentrations. Also, hand sanitizers can prevent the growth of bacteria.

 

The use of alcohol-based hand sanitizers leads to effective inhibition in the growth of staphylococcus aureus. Reducing the concentration of the hand sanitizer reduces the inhibition against MRSA.

Similarities and differences of the studies

All the studies agreed that hand hygiene is an essential factor that prevents the spread of HAIs. The studies also revealed that alcohol-based hand sanitizers (ABHS) ad antiseptic hand soaps are essential in preventing HAIs in hospitals. Besides, the studies indicated that the use of hand sanitizers leads to the inhibition of the MRSA bacteria. The (Chaudhari, 2020) study revealed that different antiseptic soaps such as Dettol, Lifebuoy Plus, and Savlon have an antimicrobial activity that inhibits MRSA growth. The effectiveness of the antiseptic soaps depends on their concentration.

 

 

 

 

 

 

 

 

References

Amadi, W. S., Patience, A. N. & Olayiwola, O. J. (2018). Comparison of antimicrobial activity of locally produced soaps and conventional medicated sops on bacterial isolates from skin and wound. World Journal of pharmaceutical and Medical Research, 4, 10, 16- 20.

Bondurant, S., McKinney, T. K., Bondurant, L. & Fitzpatrick, L. (2020). Evaluation of benzalkonium chloride hand sanitizer in reducing transient staphylococcus aureus bacterial skin contamination in healthcare workers. American Journal of Infection Control, 48, 5,  1- 5

Chaudhari, V. M. (2020). Studies on antimicrobial activity of antiseptic soaps and herbal soaps against selected human pathogens. Journal of Scientific & Innovative Research, 5, 6, 201- 204.

Kakroo, P., Shekhar, S., Pathani, K. B., Shukla, S. S., Arora, G. & Deshwal, V. K. (2020). Inhibitory effect of different hand sanitizers against staphylococcus aureus. International Journal of Scientific Research and Engineering Development, 3, 3, 269- 272.

Mathur, M. (2011). Hand hygiene: Back to the basics of infection control. Indian Journal of Medical Research, 134, 5, 611- 620. Doi: 10.4103/0971-5916.90985