EFFECTIVENESS OF HANDWASHING

Effectiveness of Hand washing To Prevent Cross Infection



Effectiveness of Hand washing To Prevent Cross Infection

In contemporary health care practice, why doesn't staff wash their hands as often as they should? And what are we, as a profession, doing about it? Hand washing is a basic and routine task. But it is also one of the very foundations on which we should base our nursing care. (Weatheral 2009:443-449)

Efforts to prevent and control health care-related infections have been ongoing for many decades. More than 100 years ago the achievements of pioneers such as Florence Nightingale and Ignaz Philip Semmelweiss were notable in reducing the risk of infection in hospitalised patients. As the modern era of health has emerged with more invasive procedures and indwelling devices, immunosuppressive therapies, and critical care units, both the intrinsic and extrinsic risks for infection have increased. (Sheena 2002:45)

Hand washing is without doubt the most important intervention in the control of cross-infection. However, many healthcare staff do not comply with the procedure. One commentator states "that hands used to care, treat and comfort may potentially become instruments of harm", while another sees hand washing as a simple but effective means of protecting patients from nosocomial infections.

Factors which contribute to a lack of hand washing include lack of education, staff shortages, excessive workload, time limits, lack of adequate facilities, eg soap and hand towels, lack of conveniently located facilities, and fear of detrimental effects on the skin. Other possible barriers to appropriate hand hygiene are cleansing agents causing skin irritation, inadequate knowledge of hand hygiene guidelines or protocols, lack of role modelling from superiors or peers, lack of recognition of the risk of cross-contamination, or simply forgetfulness.

Two researchers found that although hand washing frequency increases following education, the rate soon returns to the previous level. Although this research is more than 10 years old, it is interesting to note that when comparing it to current research, the end result is the same. An evidence-based research project carried out in the United Kingdom aimed to change health care workers' (HCW) behaviour towards hand washing. The study concluded it was one thing to offer solutions to improve hand hygiene; however, it was quite another matter to convince HCWs to continue with this good practice when the study was completed. The study then concluded that compliance with the hand washing regime needed to start at the top, i.e. with management, if it was to be successfully implemented in the workplace. (Ojajarvi 2008:275-283)

As a nursing student on clinical placements, the manager/team leaders of the areas I worked in were excellent role models to staff, patients' families and students. This role modelling encouraged very high staff compliance with the hand-washing regime. However, there were not always posters or pictures in the unit/wards displaying how and for how long one must wash one's hands. This may be satisfactory for HCWs who have had hand hygiene training, but what of the patients and visitors to these areas? In particular, when dealing ...